DR: AbirMohidien Said<br />Operative Gynaecology<br />
Operative Gynaecology<br /> About 80% of all the gyn.surgeries are elective, this means that there are other alternative t...
D&C (dilitation&curtage)<br />D&C one of the most commen minor gyn.op.<br />D&C may be a diagnostic or a therapeutic proce...
Complication of the D&C<br />Perforation of the uterus. It is not uncommen & occurs particulary with a retroverted uterus<...
Cervical conization<br />A cone shaped portion of the cervix removed therapeutic & diagnostic purposes<br />Therapeutic ( ...
Cervical conization<br />
 Laser<br />Is commonly used to treat condylomas of the cervix, vagina,perinium & vulva<br />To treat chronic cervicitis<b...
CondylomataAcuminata<br />
Laproscopy<br />Using a device called laparoscope( telescope)<br />CO2 inflation ( few liters  about 3-4 L)<br />Laproscop...
Diagnostic Laparoscopy<br />Unexplained infertility<br />Tubal patancy testing<br />Adenexal, uterin pathology congenital ...
Operative Laparoscopic<br />Tubutomy & ectopic preg. removed<br />Salpingectomy with Ectopic pregnancy<br />Salpingo oopho...
Commen complication<br />Penetrating injuries from veress needle<br />Perforation of the bowel<br />Perforetion of the blo...
Hysteroscopy<br />Now very commen, means the visualization of the endometrial & endocervicallining & the cavity by using a...
Hysteroscopy<br />
 complication<br />Perforation during cevixdilitation<br />Uterin perforation<br />Bowel or bladder damage ( diathermy )<b...
Cystoscopy<br />Full bladder with water & induced the cystoscop throw the urethra to the blader<br />Rigid or flexible cys...
Hysterectomy<br />Total hysterectomy<br />Subtotal/ supravaginal hysterectomy<br />Radical hysterectomy( Wertheim operatio...
Complication<br />Bleeding<br />Wound infection (deep or superfacial)<br />Cystitis<br />Urin retention<br />Embolism ( DV...
Urogynecological operation<br />Stress incontinens (laxity of the urethra)<br />TVT ( Tension -free Vaginal Tape)<br />TOT...
Colporrhaphy anterior<br />Cystocele repair, large cystoceles may require surgery to push up the bladder away from the vag...
Colporraphy posterior<br />Rectocele repair, occurs when rectum start to fall to the front & pushes against the back wall ...
Colporraphywith mesh<br />
THANKS<br />
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Gynecology 5th year, 1st & 2nd lectures (Dr. Abir Mohidien Said)

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The lecture has been given on May 9th & 11th, 2011 by Dr. Abir Mohidien Said.

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Gynecology 5th year, 1st & 2nd lectures (Dr. Abir Mohidien Said)

  1. 1. DR: AbirMohidien Said<br />Operative Gynaecology<br />
  2. 2. Operative Gynaecology<br /> About 80% of all the gyn.surgeries are elective, this means that there are other alternative treatments to be considered, the appropriateness of the dicision making depends on the physician & patient on an individual basis, prepair for operation is important, information about operation, risk, alternative.<br />
  3. 3. D&C (dilitation&curtage)<br />D&C one of the most commen minor gyn.op.<br />D&C may be a diagnostic or a therapeutic procedure<br />A diagnostic is performed for:<br />Premenopausal irreguler menstrual bleeding<br />Post menapausal bleeding<br />Suspected Ca. of cervix or endometium(fractional curettage)<br />Therapeutic effect with very heavy bleeding<br />
  4. 4. Complication of the D&C<br />Perforation of the uterus. It is not uncommen & occurs particulary with a retroverted uterus<br />Infection ( always 2 typs antibiotic, aerobic&nonaerobic)<br />Hemorrhage<br />Continuing pregnancy<br />Retained products of conception<br />Cervical damage<br />
  5. 5. Cervical conization<br />A cone shaped portion of the cervix removed therapeutic & diagnostic purposes<br />Therapeutic ( cervical dysplasia or chronic cervicitis)<br />Performed by using knive or loop electrosurgical excision or by laser ( give nice scar & less bleeding)<br />
  6. 6. Cervical conization<br />
  7. 7. Laser<br />Is commonly used to treat condylomas of the cervix, vagina,perinium & vulva<br />To treat chronic cervicitis<br />Dysplasia of the vulva<br />Vaporization or coagulation of endometriosis ( laproscopic)<br />
  8. 8. CondylomataAcuminata<br />
  9. 9. Laproscopy<br />Using a device called laparoscope( telescope)<br />CO2 inflation ( few liters about 3-4 L)<br />Laproscopy is two types:<br />Diagnostic laparoscopy<br />Operative Laparoscopy<br />
  10. 10. Diagnostic Laparoscopy<br />Unexplained infertility<br />Tubal patancy testing<br />Adenexal, uterin pathology congenital or acquired<br />Acute abdomen, suspected ectopic gestation<br />
  11. 11. Operative Laparoscopic<br />Tubutomy & ectopic preg. removed<br />Salpingectomy with Ectopic pregnancy<br />Salpingo oophorectomy (prophylxic,ect)<br />Exicesion of the ovarium cyst <br />Oophorectomy exicesion<br />Adhesion lysis<br />Vaporization of the endometriosis<br />LAVH<br />Sterilisation & abdominal IUD removal<br />
  12. 12.
  13. 13.
  14. 14. Commen complication<br />Penetrating injuries from veress needle<br />Perforation of the bowel<br />Perforetion of the blood vessels<br />Damage to bowel and bladder during diathermy<br />Gas embolism<br />Bleeding<br />Infection<br />
  15. 15. Hysteroscopy<br />Now very commen, means the visualization of the endometrial & endocervicallining & the cavity by using a flexible or raged telescope.<br />Diagnosis or operative<br />Diagnosis of any congenital ( uterin septum etc)<br />Operative of uterine pathology ( endometrial ,cervical polypectomy or submucus fibroids etc)<br />
  16. 16. Hysteroscopy<br />
  17. 17.
  18. 18. complication<br />Perforation during cevixdilitation<br />Uterin perforation<br />Bowel or bladder damage ( diathermy )<br />Fluid absorption ( manitol , NACL )<br />Bleeding<br />Infection<br />Air embolism<br />
  19. 19. Cystoscopy<br />Full bladder with water & induced the cystoscop throw the urethra to the blader<br />Rigid or flexible cystoscop<br />Gynaecologist used only for diagnostic, after recurrent cystitis, haematuria, suspected polyp & to se perforation, after induced tape of incontinence operation.( TVT, TOT)<br />
  20. 20.
  21. 21.
  22. 22.
  23. 23. Hysterectomy<br />Total hysterectomy<br />Subtotal/ supravaginal hysterectomy<br />Radical hysterectomy( Wertheim operation)<br />Total hyterectomy with bilatral/unilateral salpingo-oophorectomy<br />Vaginal hysterectomy<br />LAVH (laproscopically-assisted vaginal hysterectomy)<br />
  24. 24. Complication<br />Bleeding<br />Wound infection (deep or superfacial)<br />Cystitis<br />Urin retention<br />Embolism ( DVT, lung)<br />Damage to the intestine, blader, ureter)<br />Sever painfull<br />Complication of GA <br />
  25. 25. Urogynecological operation<br />Stress incontinens (laxity of the urethra)<br />TVT ( Tension -free Vaginal Tape)<br />TOT ( Trans Obturator Tape)<br />Burch operation (permanent stitches are placed near the neck of the bladder and fixed to the back of the pubic) <br />
  26. 26.
  27. 27. Colporrhaphy anterior<br />Cystocele repair, large cystoceles may require surgery to push up the bladder away from the vagina & support it so it will stay in anormal position<br />Complication: bladder perforation,urgeincontinence,infection & bleeding<br />
  28. 28.
  29. 29. Colporraphy posterior<br />Rectocele repair, occurs when rectum start to fall to the front & pushes against the back wall of the vagina<br />Push up the rectum away from the vagina & support it so it will stay in amore normal position<br />Complication : intestine perforation, infection, bleeding,stenosis of vagina & dysparunia<br />
  30. 30.
  31. 31. Colporraphywith mesh<br />
  32. 32. THANKS<br />

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