Sunday, February 26, 2012

Hysterectomy

Types of hysterectomy

Abdomen Hys
  • TAH
  • - Sub total hysterectomy
  • Total hysterectomy with b/l salpingoophorectomy
  • Extended hysterectomy
  • Radical hysterectomy

Vagina hyst. (VH)
LA VH

Indication

Benign disease

Abn bleeding
Leiomyoma
Endometriosis
Ut prolapse
Chronic PID with tuboovarian mass
Caesarean Hyst.
Molar preg >40 age
Septic abortion
Chronic inversion of Ut

Malignant

Ca Cx
Ca EM
Ca ovary
Ca fallopian tube
Gestational TD

Preparation

Complete physical and anesthetic evaluation

Routine blood test
  • Full blood count
  • CXR
  • ECG
  • Bowel preperation

Technique for TAH

  • Supine position
  • Abdo wall open in layers
  • Self retaining retractors
  • Trendelenberg position
  • Pack intestine


Complication of operation

Immediate complications

Anasthesia compl
Bleeding, haemotama
Injury to the surrounding structure
Intestine, bladder, ureter,

Early complications

Atelactasis, UTI, DVT, wound Infection, burst abdomen, vault prolapse

Remote complication

keloid, vault granulation, vault prolapse, incisional hernia, psy and emotional problem


Follow up

Histo path
Counselling
Nutrition

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