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This resource is a brand new version of a best-selling advisor to tactics keen on gynecologic oncology. With particularly unique annotated images, the reader is led rigorously via each step of the operations lined.
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Additional resources for Atlas of Procedures in Gynecologic Oncology, Second Edition
The sartorius can be transposed by transecting it with electrocautery at its tendinous attachment to the anterior superior iliac spine. It is then used to cover the vessels by suturing it to the inguinal ligament and pectineal fascia with interrupted delayed absorbable sutures. 25. Lymphoscintigram. In patients undergoing sentinel node biopsy, both radioisotope and blue dye are used to help in accurate localization of the sentinel node. In the Nuclear Medicine Department, an injection with filtered technetium-99m sulfur colloid is performed.
11. Unroofing the ureter. The ureter is unroofed through the parametrial tunnel to its insertion into the bladder. This is accomplished with blunt and sharp dissection using a right-angled clamp and suture ligatures as needed. Unroofing the ureter allows complete mobilization of the parametrium toward the specimen. The parametrial tissue can be seen attached to the cervix. Care should be taken during this dissection, and small vessels should be ligated with suture ligatures or hemoclips, since significant blood loss can occur during this part of the procedure.
The lymphatic tissue around the node is dissected with a hemostat and electrocautery. 34. Sentinel node identification. Any node that exhibits radioactivity or blue dye is removed. 35. Specimen showing a blue sentinel node. 36. Postexcision counts. The lymphatic basin is checked for residual radioactivity after removal of the sentinel node, and any discrete residual radioactivity is pursued. The counts should be minimal, with a more than 4- to 10-fold reduction over the maximum counts obtained at that site at the outset of the procedure.