Gynecologic and Obstetric Surgery

Contributors, x Preface, xv List of Abbreviations, xvi Part I: General Preoperative, Intraoperative, and Postoperative Challenges Section 1: Preoperative Care Editors: Phil Moore and Arri Coomarasamy 1 Patient with Poor ASA Score, 3 Phil Moore 2 Patient on Medication, 6 Arri Coomarasamy 3 Patient with Ischemic Heart Disease, 9 Sohail Q. Khan and Jonathan N. Townend 4 Patient with Arrhythmias, 13 Sanoj Chacko and Joseph de Bono 5 Patient with a Pacemaker or Implantable Defibrillator, 17 Howard Marshall 6 Patient with Complex Congenital Heart Disease (Fontan Circulation), 20 Yaso Emmanuel and Sara A. Thorne 7 Hypertensive Patient, 22 Aarthi R. Mohan and Catherine Nelson-Piercy 8 Patient with Respiratory Disease, 25 Heinke Kunst 9 Patient with Diabetes, 28 Arri Coomarasamy and Dukaydah van der Berg 10 Patient with Thyroid Disease, 30 Ramy Labib and Shiao-yng Chan 11 Patient with Renal Disease, 33 Khalid Hasan 12 Patient with Liver Disease, 35 Joanna K. Dowman and Philip N. Newsome 13 Patient with Rheumatologic Diseases, 38 Amita A. Mahendru and Justin Chu 14 Patient with Hematologic Disorders, 41 Chieh Lin Fu 15 Patient at High Risk of Venous Thrombosis, 44 Ian A. Greer 16 Patient on Anticoagulant Therapy, 47 Sophie Lee and Will Lester 17 Patient on Steroid Therapy, 50 Shaista Nazir and John Ayuk 18 Patient with Epilepsy, 54 Danita Jones and Virgilio Salanga 19 Patient with a Psychiatric Condition, 56 Idnan Yunas 20 Patient with Organ Transplant, 59 Sarah Winfield 21 Patient with Hepatitis B or C, 61 Firas Al-Rshoud and Arri Coomarasamy 22 Patient with HIV, 64 Firas Al-Rshoud and Arri Coomarasamy 23 Obese Patient, 67 Phil Moore 24 Patient with Poor Nutritional Status, 69 Phil Moore 25 Pregnant Patient Requiring Non-obstetric Surgery, 71 Arri Coomarasamy Section 2: Intraoperative Care Editors: Arri Coomarasamy and Mahmood I. Shafi 26 Transverse Incision on the Abdomen Inadequate for Surgery, 77 Arri Coomarasamy 27 Previous Multiple Abdominal Scars, 79 Mohammed Khairy and Arri Coomarasamy 28 Patient with Previous Mesh Incisional Hernia Repair Requiring a Laparotomy, 83 Christopher Smart and Chris Keh 29 Patient with Previous Mesh Incisional Hernia Repair Requiring a Laparoscopy, 86 Emanuele Lo Menzo, Samuel Szomstein, and Raul J. Rosenthal 30 Unexpected Pathology: Ovarian Cyst, 89 Mohan Kumar 31 Unexpected Pathology: Abnormal Appearance of the Uterus, 92 Arri Coomarasamy 32 Unexpected Pathology: Severe Pelvic Adhesions, 94 Stephen E. Zimberg and Michael L. Sprague 33 Unexpected Pathology: Abnormal Appearance of Bowel, 97 Olivia Will and Justin Davies 34 Unexpected Pathology: Retroperitoneal Mass, 100 Mohamed Mehasseb 35 Bladder Injury, 103 Arri Coomarasamy and Richard Popert 36 Ureteric Injury, 106 Arri Coomarasamy and Richard Popert 37 Small and Large Bowel Injury, 111 Howard Joy 38 Inferior Epigastric Vessel Injury, 116 Manas Chakrabarti and Sudha Sundar 39 Bleeding from Retracted Pedicular (Pelvic Sidewall) Vessels, 119 Michael L. Sprague and Stephen E. Zimberg 40 Massive Hemorrhage, 121 Karen Louise Moores, William Parry-Smith, and Martyn Underwood 41 Broken Needle, 125 Joanne Kathleen Ritchie, Anuradha Radotra, and Martyn Underwood 42 Lost Swab, Needle or Instrument, 127 Joanne Kathleen Ritchie, Martyn Underwood, and William Parry-Smith Section 3: Postoperative Care Editors: Arri Coomarasamy and Janesh Gupta 43 Postoperative Care, 131 Janesh Gupta, Robbert Soeters, and Aaron Ndhluni 44 Excessive Nausea and Vomiting after Surgery, 133 Phil Moore 45 Excessive Abdominal Pain after Surgery, 136 Manjeet Shehmar 46 Bowel Damage: Postoperative Presentation, 139 Ketan Gajjar and Mahmood I. Shafi 47 Wound Infection, 142 Pallavi Latthe and James Gray 48 Wound Dehiscence, 147 T. Justin Clark 49 Late Wound Failure: Incisional Hernia, 150 Saloney Nazeer 50 Necrotizing Fasciitis, 153 Tariq Ahmad 51 Management of Surgical Drains, 156 Ahmed M. El-Sharkawy and Sherif Awad 52 Shocked Patient, 159 Manjeet Shehmar 53 Breathless Patient: Postoperative Pulmonary Complications, 162 Heinke Kunst 54 Confused Postoperative Patient, 165 Idnan Yunas 55 Patient with Poor Urine Output, 167 Amelia Davison and Jackie A. Ross 56 Electrolyte Imbalance, 170 Manjeet Shehmar and Arri Coomarasamy 57 Swollen Leg, 174 Edwin Stephen, Indrani Sen, and Tim Lees 58 Cardiorespiratory Arrest, 177 Jennie Kerr PART II: Operations and Challenges Section 4: General and Minimal Access Gynecology Editors: T. Justin Clark, Kiong K. Chan, and Arri Coomarasamy 59 Difficulty in Dilating the Cervix: Cervical Stenosis and Cervical Closure, 183 Arri Coomarasamy 60 Uterine Perforation, 186 Arri Coomarasamy 61 Surgical Uterine Evacuation: Excessive Bleeding, 189 Rajesh Varma 62 Surgical Uterine Evacuation in a Woman with Multiple Fibroids, 191 Rajesh Varma 63 Use of Excessive Distension Media at Hysteroscopy, 194 Arri Coomarasamy 64 Hysteroscopy: Endometrial Resection and Ablation in the Abnormal Uterine Cavity, 197 Alessandro Conforti and Adam Magos 65 Laparoscopy in a Pediatric Patient, 199 Suketu M. Mansuria, Cara R. King, and Arri Coomarasamy 66 Safe Laparoscopic Entry in a Thin Patient, 202 Janesh Gupta and Justin Chu 67 Laparoscopy: Unable to Gain Entry, 205 Mohamed Mehasseb 68 Surgical Emphysema, 208 Arri Coomarasamy 69 Venous Air Embolism, 210 Anneke Chu and Jennie Kerr 70 Laparoscopy: Problems with Monopolar Diathermy, 213 Thomas G. Lang and Resad Pasic 71 Laparoscopy: Problems with Bipolar Diathermy, 216 Thomas G. Lang and Resad Pasic 72 Laparoscopy: Bladder Injury, 218 Peter L. Rosenblatt 73 Laparoscopy: Ureteric Injury, 221 Peter L. Rosenblatt 74 Bowel Injury During Laparoscopy: Intraoperative Presentation, 224 Alan Lam 75 Bowel Injury After Laparoscopy: Late Presentation, 227 Alan Lam 76 Blood Vessel Injury at Laparoscopy, 230 Elizabeth Ball 77 Laparoscopy for Large Ovarian Cyst, 233 T. Justin Clark 78 Laparoscopy for an Ovarian Cyst in Pregnancy, 235 T. Justin Clark 79 Laparoscopic Removal of Rectovaginal Endometriosis, 238 Alan Lam 80 Laparoscopic Myomectomy, 242 Ertan Saridogan 81 Total Laparoscopic Hysterectomy, 245 Alan Farthing 82 Laparoscopic Hysterectomy for a Large Fibroid Uterus, 247 Alan Lam 83 Laparoscopy: Difficulty in Tissue Retrieval, 250 Su-Yen Khong and Alan Lam 84 Surgery for Cornual or Interstitial Pregnancy, 253 Ayesha Mahmud and Yousri Afifi 85 Surgery for Cervical Ectopic Pregnancy, 256 Bassel H. Al Wattar and Yousri Afifi 86 Surgery for Cesarean Scar Pregnancy, 259 T. Justin Clark 87 Surgery for Adnexal Torsion, 262 Mohamed Otify and Jackie A. Ross 88 Laparoscopic Appendectomy, 264 Edward Rawstorne, Christopher Smart, and Chris Keh 89 Laparoscopic Surgery: When to Convert to Laparotomy?, 267 Mohamed Mehasseb 90 Laparoscopy: Port-site Herniation, 269 Ayesha Mahmud and Yousri Afifi Section 5: Reproductive Surgery Editors: Arri Coomarasamy and Mahmood I. Shafi 91 Uterine Septum, 275 Basim Abu-Rafea and Khaldoun Sharif 92 Surgery for Intrauterine Adhesions, 278 Mohan Kumar 93 Myomectomy: Breach of the Endometrial Cavity, 280 Masoud Afnan and Arri Coomarasamy 94 Myomectomy: Multiple Large Fibroids, 282 Justin Chu and Arri Coomarasamy 95 Myomectomy: Massive Intraoperative Hemorrhage, 284 Neelam Potdar and Arri Coomarasamy 96 Vaginal Myomectomy, 287 Adam Magos 97 Surgery for Proximal Tubal Blockage, 289 Spyros Papaioannou 98 Surgery for Distal Tubal Disease, 292 Lynne Robinson, Hemant N. Vakharia, and Yousri Afifi 99 Reversal of Sterilization, 295 Hemant N. Vakharia, Lynne Robinson, and Yousri Afifi 100 Surgery for Congenital Abnormalities of the Genital Tract, 299 Naomi S. Crouch 101 Surgical Sperm Retrieval, 304 David Muthuveloe and Y. Zaki Almallah Section 6: Urogynecologic Surgery Editors: Pallavi Latthe and G. Willy Davila 102 Sling Procedures: Bladder Injury, 309 Fidan Israfil-Bayli and Philip Toozs-Hobson 103 Sling Procedures: Urethral Injury, 311 Gamal M. Ghoniem 104 Sling Procedures: Retropubic Hematoma, 314 Fidan Israfil-Bayli and Philip Toozs-Hobson 105 Sling Procedures: Bowel Injury, 316 Fidan Israfil-Bayli and Philip Toozs-Hobson 106 Sling Procedures: Voiding Dysfunction after Stress Urinary Incontinence Surgery, 318 Margarita M. Aponte and Victor W. Nitti 107 Sling Procedures: Tape Erosion into the Bladder, 321 Samuel J.S. Grimsley and Y. Zaki Almallah 108 Sling Procedures: Sexual Dysfunction, 323 Swati Jha and Ranee Thakar 109 Sling Procedures: Persistent Urine Leakage, 325 Luis Manuel Espaillat-Rijo and G. Willy Davila 110 Difficult Vaginal Hysterectomy, 329 G. Willy Davila 111 Vaginal Hysterectomy: Difficulty in Entering the Posterior Pouch, 332 Alfredo Jijon and G. Willy Davila 112 Salpingo-oophorectomy at the Time of Vaginal Hysterectomy, 335 Alfredo Jijon and G. Willy Davila 113 Bladder Injury During Anterior Vaginal Repair or Vaginal Hysterectomy, 338 Pallavi Latthe, Suneetha Rachaneni, and Mohammed Belal 114 Difficult Sacrocolpopexy, 341 Orfhlaith E. O'Sullivan and Barry A. O'Reilly 115 Difficult Sacrospinous Fixation, 345 Smita Rajshekhar and Rohna Kearney 116 Recurrent Pelvic Organ Prolapse, 348 Monika Vij and Robert Freeman 117 Colpocleisis, 351 Kalaivani Ramalingam and Ash Monga 118 Uterine Suspension Procedures: Laparoscopic Hysteropexy, 353 Natalia Price and Simon Jackson 119 Mesh Tape Exposure Following Tension-free Vaginal Tape, 356 Helen Bolton and Mark Slack 120 Vaginal Vault Evisceration, 360 Swati Jha 121 Complications in Laparoscopic Pelvic Floor Surgery, 362 Nir Haya and Christopher Maher 122 Robotic Urogynecology Procedures, 367 Orfhlaith E. O'Sullivan and Barry A. O'Reilly 123 Complications in Robotic Pelvic Floor Surgery, 370 Amie Kawasaki 124 Neovagina, 372 Lynsey Hayward and G. Willy Davila 125 Vaginal Stricture After Pelvic Organ Prolapse Surgery, 375 Ted M. Roth, G. Rodney Meeks and G. Willy Davila 126 Urethral Diverticula and Other Periurethral Masses, 378 Bhavin Patel and Kathleen C. Kobashi 127 Vesicovaginal Fistulae, 382 Karolynn T. Echols,Tamara V. Toidze, and Edward Stanford 128 Urethrovaginal Fistulae, 386 Sohier Elneil 129 Rectovaginal Fistulae, 389 Claire Burton and Simon Radley 130 Secondary Anal Sphincter Repair, 392 Steven D. Wexner and Emanuela Silva Section 7: Gynecologic Oncology Editors: Kavita Singh, Mahmood I. Shafi, and Kiong K. Chan 131 Large Loop Excision of the Transformation Zone, 399 Mahmood I. Shafi 132 Knife Cone Biopsy, 401 Najum Qureshi 133 Staging Procedures: Examination Under Anesthesia, Cystoscopy, Sigmoidoscopy, and Biopsy Techniques, 403 Mahmood I. Shafi 134 Radicality of Surgery for Cervical Cancer, 406 Mahmood I. Shafi 135 Pelvic and Para-aortic Lymphadenectomy in Gynecologic Cancers, 408 Kavita Singh and Rami Fares 136 Trachelectomy for Treatment of Cervical Cancer, 412 Kavita Singh and Janos Balega 137 Laparoscopic Radical Surgery for Cervical Cancer, 414 Mohamed Mehasseb 138 Groin and Retroperitoneal Lymphocele, 416 David M. Luesley 139 Laparotomy for a Pelvic Mass of Uncertain Nature, 418 Mahmood I. Shafi 140 Gynecologic Cancer Extending to the Bowel, 420 Kiong K. Chan 141 Omental Procedures: Supracolic Omentectomy, Infracolic Omentectomy, and Omental Biopsy, 423 Kiong K. Chan 142 Diaphragmatic Surgery in Advanced Ovarian Cancer, 425 Ariella Jakobson-Setton and Kavita Singh 143 Fine-needle Aspiration Biopsy of Superficial Groin Lymph Node, 428 Moji Balogun 144 Vulval Surgery: Wide Local Excision and Vulvectomy, 431 Mahmood I. Shafi 145 Sentinel Node Biopsy in Gynecologic Cancer, 433 Kavita Singh 146 Groin Lymphadenectomy, 435 Ketan Gajjar 147 Plastic Surgical Techniques in Vulval or Perineal Procedures, 438 Mahmood I. Shafi 148 Vaginectomy, 441 Janos Balega and Kavita Singh 149 Urinary Diversion, 443 John Parkin 150 Pelvic Exenteration, 446 Kavita Singh 151 Gynecologic Cancer and Concurrent Pregnancy, 449 Nirmala Rai Talapadi and Sudha Sundar Section 8: Obstetric Surgery Editors: Pallavi Latthe, Kiong K. Chan, and Arri Coomarasamy 152 Ovarian Cyst Identified at Cesarean Section, 455 Kiong K. Chan and Ioannis Gallos 153 Laparoscopy in Pregnancy, 457 Kevin J.E. Stepp and Anjana Nair 154 Cervical Cerclage, 459 Ayesha Mahmud and Yousri Afifi 155 Cesarean Section in a Woman with Fibroids, 463 Andrew Prentice 156 Cesarean Section at the Limits of Viability, 465 Catherine Aiken and Jeremy Brockelsby 157 Difficult Delivery of the Fetal Head During Cesarean Section, 468 Parveen Abedin 158 Surgical Management of Massive Obstetric Hemorrhage from the Uterus, Cervix, or Vagina, 470 Phil Steer 159 Surgical Management of Placenta Praevia, 475 Vibha Giri and Mohan Kumar 160 Surgical Management of Placenta Accreta, 479 Vibha Giri and Mohan Kumar 161 Surgical Management Options for Shoulder Dystocia: Zavanelli Maneuver, Abdominal Rescue, Symphysiotomy, and Cleidotomy, 482 Syeda Batool Mazhar and Asia Nazir 162 Uterine Inversion, 485 Phil Steer 163 Episiotomy and Second-degree Tear, 488 Khaled M.K. Ismail and Sara S. Webb 164 Obstetric Anal Sphincter Tear, 490 Natalie P. Nunes, Helen Stevenson, and Matthew Parsons 165 Pregnancy and Female Genital Mutilation, 493 Naomi Low-Beer and Gubby Ayida 166 Destructive Operations on a Dead Fetus, 496 Hany Abdel-Aleem 167 Development of a Basic Obstetric Theater Facility in a Low-resource Setting, 499 Zahida Qureshi and Alfred Murage Section 9: Miscellaneous Editors: Mahmood I. Shafi and Arri Coomarasamy 168 Enhanced Recovery, 505 Manjeet Shehmar 169 Major Surgery in a Jehovah's Witness Patient, 507 Martyn Underwood and William Parry-Smith 170 Termination of Pregnancy at Advanced Gestation, 509 Rohan Chodankar and Janesh Gupta 171 Cervical Fibroids: Techniques for Myomectomy and Hysterectomy, 511 Deborah R. Karp 172 Hysterectomy for Broad Ligament Fibroids, 514 Kiong K. Chan 173 Hysterectomy for a Double Uterus, 516 Kiong K. Chan 174 Cervical Stump Excision, 518 Kiong K. Chan 175 Surgery for Ovarian Remnant, 520 Kiong K. Chan and Arri Coomarasamy 176 Surgery for Missing Intrauterine Contraceptive Device, 522 Toh Lick Tan 177 Management of Imperforate Hymen, Transverse and other Vaginal Septa, 525 Jane MacDougall 178 Benign Lesions in the Groin and Vulva, 528 Jennifer Byrom 179 Cystic Structure in the Upper Vagina, 531 Ted M. Roth and G. Rodney Meeks 180 Adnexal Masses in Infants and Children, 533 Rachel J. Miller and Kris Ann P. Schultz 181 Nerve Injuries Associated with Gynecologic and Obstetric Surgery, 536 Djavid Alleemudder 182 Consent Challenges, 540 William Parry-Smith and Martyn Underwood 183 Dealing with Complaints, 542 Mahmood I. Shafi 184 Dealing with Litigation, 544 Rebekah Ley and Mahmood I. Shafi Index, 547