Operations Flashcards
describe process of hysteroscopy
NSAIDs 1 hour before
insert speculum
miniature hysteroscope
dilate uterus with saline
insert instruments through hysteroscope
when is ovarian cystectomy done
causing Sx or cancer
how is ovarian cystectomy done and when is each favoured
laparotomy - large / cancer
laparascopic
what risk is there with removal of ovarian cyst
rupture inside abdomen –> peritonitis or spread of cancer
when doing diagnostic laparoscopy, what are the risks
damage to bladder
damage to bowel
infection
hysterectomy
to what pressure is the abdomen inflated to for laparoscopy
20mmHg
when is open myomectomy done
menorrhagia
subfertility
pressure Sx
what is an alternative to open myomectomy
IUS
uterine artery embolisation
hysterectomy
benefits & risk of morcellation of fibroid after removal
benefits - less blood loss, less post op pain
risks - pieces of fibroids left, spread of uterine sarcoma
when is hysteroscopic myomectomy done
submucous and intracavity fibroids
who is endometrial ablation done on
> 45 y/o
regular menorrhagia
no desire to preserve fertility but no hysterectomy
when can GnRH analgoues be used
pre endometrial ablation or myomectomy surgery to shrink fibroids
how is endometrial ablation done
resetoscope - remove submucosal fibroids
electroablation - rollerball
thermal ablation
describe types of hysterectomy
partial - just uterus
total - uterus and cervix
radical - uterus, cervix, ovaries and tubes
risks of laparascopic sterilisation “tying tubes”
failure
GA risks
invasive vs vasectomy
