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Chapter-03 Vaginal Surgeries in Case of Previous Abdominal Surgeries

BOOK TITLE: Manual of Vaginal Hysterectomy

Author
1. Sheth Shirish S
2. Paghdiwalla Kurush P
ISBN
9789352703685
DOI
10.5005/jp/books/18027_4
Edition
1/e
Publishing Year
2018
Pages
4
Author Affiliations
1. Breach Candy Hospital, Sir Hurkisondas Nurrotamdas Hospital and Sheth Nursing Home, 2/2, Navjivan Society, Lamington Road, Mumbai, India, e-mail:silsal@bom2.vsnl.net.in, Breach Candy Hospital and Sir Hurkisondas Nurrotamdas Hospital, Mumbai, silsal@bom2.vsnl.net.in, Sir Hurkisondas Nurrotamdas and Saifee Hospitals, Mumbai, Maharashtra, India, Breach Candy Hospital and Sir Hurkisondas Nurrotamdas Hospital, Mumbai, Maharashtra, India, Breach Candy Hospital, Sir Hurkisondas Hospital and Saifee Hospital, Mumbai, Maharashtra, India, Mumbai, King Edward Memorial Hospital and Seth GS Medical College, Mumbai, Maharashtra, India (1964–1994); International Federation of Gynecology and Obstetrics (FIGO) from 2000–2003; Breach Candy and Saifee Hospitals, Mumbai, Maharashtra, India
2. Parsee General Hospital and Masina Hospital, Mumbai, Maharashtra, India, Breach Candy, Masina, Saifee and BD Parsee General Hospitals, Mumbai, Maharashtra, India, Mumbai
Chapter keywords
Vaginal surgery, uterus, cesarean section, myomectomy, hysterotomy, ventrofixation, hysterectomy

Abstract

This chapter describes vaginal surgeries in case of previous abdominal surgeries. Vaginal surgery, commonly hysterectomy after previous abdominopelvic surgery can test the surgical skills of the operating surgeon to the limit. The surgeon requires access to both pouches and familiarity with the ‘landmarks’. It is not obligatory to open the peritoneum at the start of surgery, as long as the bladder and rectum are well separated, protected and kept out of harm’s way by the bladder retractor and speculum respectively. The most common surgical procedures performed on the uterus are cesarean section, myomectomy, and hysterotomy, demanding extra care, but do not constitute a contraindication. Ventrofixation, an obsolete procedure, contraindicates vaginal hysterectomy as a result of a mechanical factor except in very experienced hands.

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