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Flashcards in Gynaecological Surgery Deck (3)
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1

Describe a Maylard incision. 

The critical difference between a Maylard and a Pfannensteil is transection of the rectus muscles. The skin incision itself is often 3cm to 8cm above the symphysis depending on the surgery. 

Advantages: better access, possibly better cosmesis.
Disadvantages: more pain, greater distortion of anatomy.

2

Discuss the advantages and disadvantages of the vaginal approach. 

Advantages include no scar, less pain and early mobilisation. In obese women there is a reduced risk of wound infection. 

Disadvantages include limited access. 

 

Relative contraindications include a uterine size over 12 weeks or pelvic adhesions due to endometriosis or pelvic inflammatory disease.  

3

What is the prevalence of BRCA gene mutations?

Between 0.1 and 0.8 percent. Women of Ashkenazi Jewish heritage are somewhat higher at 2.3 percent.