Fig. 8.1
(a, b) Equipment and patient position during hysterectomy or myomectomy
Specific surgical drapes are used.
Laparotomic Instrument Table Must Be Always Ready for Use.
Myomectomy Surgical Steps
1.
Uterine cannulation
2.
Landmark recognition
3.
Myoma enucleation
4.
Hemostasis and suture if needed
5.
Myoma morcellation or extraction
Hysterectomy Surgical Steps
1.
Uterine cannulation
2.
Landmark recognition
3.
Coagulation and section of round ligament
4.
Coagulation and section of utero-ovaric ligament
5.
Coagulation and section of large ligament
6.
Coagulation and section of uterosacral ligament
7.
Coagulation and section of uterine vessels
8.
Uterovesical freeing
9.
Section of the vagina
10.
Uterine morcellation or extraction, vaginal suturing
Ovarian Cyst Excision Surgical Steps
1.
Uterine cannulation if needed
2.
Landmark recognition
3.
Cyst enucleation
4.
Hemostasis and suture if needed
5.
Cyst extraction
Instruments and Cables
30 and 5/10 mm laparoscope
Cold light source cable
CO2 pipe and filter
Monopolar electrocautery
Patient return electrode (REM)
Two sterile instrument bags
Monopolar and bipolar electrocautery cables
Ultrasonic dissector/radiofrequency dissector and cables
Irrigation/suction laparoscopic device
Bladder catheterization set
Uterine Neck Cannulation (Fig. 8.2a)
Uterine manipulator set
Vaginal retractors
Two Pozzi forceps (for uterine neck)
Hegar dilatators
Speculum
Vaginal Instrument Table (Fig. 8.2c)
Sutures: 0 braided absorbable suture and skin wound closure sutures
Anterior retractor
Posterior retractor
Two Breisky retractors
Surgical scalpel blade No. 23
Mayo scissors
Mayo scissors (bigger)
Metzenbaum scissors
Two 18–20 cm long tissue forceps with teeth
Two anatomical thumb forceps
Two Debakey forcepsRelated posts:
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