By Mitchel S. Hoffman
Knowledge of and event with the elemental means of vaginal hysterectomy isn't univers al. each one health professional needs to learn how to establish and savour the scale of person edition in anatomic findings and hence surgical technical judgements and their execu tion from one sufferer to a different. unforeseen surgical trouble will be envisioned, yet finally it truly is handled retrospectively. expert practitioners needs to examine the actual sufferer and her challenge comprehensively and make allowance for such person diversifications in locate ings and technical wishes as are essential to the surgical answer for that patient's challenge. spotting those elements, Drs. Hoffman and Spellacy have orga nized and ready a entire monograph bearing on this very genuine scientific entity. they've got reviewed the adventure of con transitority surgeons and combined those suggestions with their very own event in an invaluable compendium of surgical wisdom approximately this crucial topic. Their monograph is usually recommended now not as an alternative for the various different fantastic surgical texts to be had to the reader yet as a complement to the surgeon's library. it's for these surgeons who, having mastered the fundamental ideas, are in terested in extending the frontiers of private wisdom of this provocative topic and properly broadening the indicators for effec tive surgical procedure and reconstruction. David H. Nichols, M.D., F.A.C.S., F.A.C.O.G.
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Extra info for The Difficult Vaginal Hysterectomy: A Surgical Atlas
A) Transvaginal myomectomy. (B) Readily accessible midline leiomyoma. (C) Transvaginal delivery of a large myoma.
Obstet GynecoI31:83-89, 1968 10. Livengood CH III, Addison W A. Adnexal abscess as a delayed complication of vaginal hysterectomy. Am J Obstet Gynecol 143:596-597, 1982 11. Perineau M, Monrozies X, Reme JM. Complications of hysterectomy. Rev Fr Gynecol Obstet 87:120-125,1992 12. Pratt JH, Daikoku NH. Obesity and vaginal hysterectomy. J Reprod Med 35:945-949, 1990 13. Pratt JH, Galloway JR. Vaginal hysterectomy in patients less than 36 or more th an 60 years of age. Am J Obstet Gynecol 84:123-128, 1962 14.
5. Enlarged Uterus 5. Enlarged Uterus 57 lost if it is realized without undue delay that the hysterectomy would be better completed transabdominally. Preparation Most uteri considered for transvaginal morcellation are enlarged owing to leiomyomas, although in sorne cases the enlargement is the result of diffuse adenomyosis. When contemplating transvaginal morcellation of the uterus the surgeon must be confident that no uterine malignancy is present. The patient who is to undergo transvaginal removal of an enlarged uterus should be typed and cross-matched for possible blood transfusion and be scheduled for a longer th an usual operative time.