Gynecologic and obstetric surgery is a craft that requires sound knowledge and skills. The specifics of each individual case must be understood to enable the best surgical management approach and to minimize complications. This resource book offers insightful management options to many of the challenges a gynecologic or obstetric surgeon may face before, during and after an operation. Divided into two sections, the book first covers general preoperative, intraoperative and postoperative challenges and, second, specific surgical procedures. It provides advice on both general gynecologic and obstetric operations, as well as subspecialist areas such as reproductive surgery, urogynecology and gynecologic oncology. The chapters are concise, beginning with illustrative case histories followed by background, management options, and any preventative approaches. Designed to guide the surgeon to safe practice throughout all stages, they offer practical and step-by-step help.
Autorentext
Arri Coomarasamy, MBChB, MD, FRCOG. Professor of Gynaecology, Institute of Metabolism and System Research, University of Birmingham. Consultant Gynaecologist and Sub-specialist in Reproductive Medicine and Surgery, Birmingham Women's Hospital, Birmingham, United Kingdom.
Mahmood I. Shafi, MBBCh, MD, DA, FRCOG. Consultant Gynecological Surgeon and Oncologist, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
G. Willy Davila, MD, FACOG. Center Director, Women's Health Institute (Florida), Chairman, Department of Gynecology, Head, Section of Urogynecology and Reconstructive Pelvic Surgery, Cleveland Clinic Florida, Weston/Fort Lauderdale, Florida, United States.
K. K. Chan, MBBS, FRCS, FRCOG. Emeritus Consultant Gynecological Oncologist, Pan-Birmingham Gynecological Cancer Centre, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust. Birmingham, United Kingdom.
Inhalt
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 Ev…