4. • Vertical incision: lateral tension, widers scars
• Pfannenstiel incision: heal well with cosmetic
scar
5.
6.
7.
8.
9.
10. Common sites of injury:
1. Pelvic brim area during
infundibulopelvic ligament clamping
2. The isthmic region during uterine
artery ligation
3. The pelvic sidewall during
uterosacral ligament suturing
4. The lateral vaginal apex during
vaginal cu clamping or suturing.
11.
12. Ovarian cystectomy
• Procedure whereby the cyst is
removed without compromising the
function of the ovary
• Point of caution:
• Remove entire cyst wall, prevent
ruptured
• Hemostatis
• Indication
• Benign ovarian mass
• Ovarian preservation young
woman bilateral ovarian mass
15. Salpingektomy
• Removal of the fallopian tube while
leaving the uterus and ovary intact
• Point of caution:
• Cornual and mesosalpinx
extremely vascular areas,
hemostatis mus be insured
• Indication:
• Tubal ectopic pregnancy
• Hydrosalping
• Sterilization
16. 1. Identification of adnexa
2. The cornual portion of tube is
clamped, rest of fallopian
tube elevated with Babcok
clamp
3. Repeated fenestration in the
mesosalpinx to be clamped
and hemostatis
4. And the tube can be excised
17.
18. Salpingo-Oophorectomy
• Removal of the ovary and fallopian
tube
• Point of caution:
• Infundibulopelvic ligament
should be divided at least 2 cm
proximal/cephalad to the ovary
at the level of the pelvic brim to
ensure all ovarian tissue is
removed
• Identified ureter location
• Indication
• Ovarian mass
• PID (TOA)
19.
20.
21. Myomectomy
• Removal of fibroid
• Point of caution:
• Identification of fibroid location
• Use of uterine tourniquet
(catheter/bonney clamp) or
vassopresin to reduce blood loss
• Indication:
• Symptomatic myoma:
• AUB
• Chronic pain
• Urinary obstruction
• Asymptomatic myoma
• RPL
• Infertility
