Federation of Obstetric and Gynaecological Societies of India
Shobhana
M
MD DGO Dip Endoscopy Surgery (Germany)
Consultant Gynecologist and Endoscopic Surgeon Department of Infertility and Key Hole Surgery Elite Mission Hospital
Thrissur (Kerala)
Aneesh
Sabnis
DNB FCPS DGO DFP
Dip Endoscopic Surgery (Germany) Consultant Gynecologist Obs. and Gyn. Endoscopic Surgeon Sneh Nursing Home and Centre for Gyn. Endoscopic Surgery
Andheri (E), Mumbai
Foreword
PK
Shah
A FOGSI Publication
Jitendar P Vij
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Textbook on Complications in Gynecological Surgery
© 2006, Federation of Obstetric and Gynaecological Societies of India
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2006
9788180617140
Typeset at JPBMP typesetting unit
Printed at Raplika
- Professor Dr. Med. Liselotte Mettler
- Head of Kiel School of Gynecological Endoscopy and
- Human Reproduction
- Past President of the Eur. Society of Gynecological
- Endoscopy
- Past President of the German Society of
- Gynecological Endoscopy
- Past-President of the German Society of Fertility and
- Sterility
- Active Board Member of the Int. Society of
- Gynecological Endoscopy and the Int. Society for
- Fertility and Sterility (IFFS)
- President of the German-French Society of
- Gynecology
- Director of the Dept of Reproductive Biology,
- Endoscopy and Endocrinology,
- University of Kiel: On the Editorial Board of:
- Reproduktionsmedizin, Eur. J of Gyn. Endoscopy,
- American J of Gyn. Endoscopy
- Shlomo B Cohen MD
- Dept. of Obstetrics and Gynecology
- Sheba Medical Center, Tel-Hashomer, 52621
- Affiliated with Tel-Aviv University, Israel
- Shyam V Desai MD DGO DFP FCPS MNAMS FICOG
- Dip. Pelvioscopic Surgery (Germany)
- Honorary Prof. N. Wadia Maternity Hospital, Mumbai
- President-Federation of Obstetric and Gynecological
- Societies of India 2005
- Past President Indian Association of Gynecological
- Endoscopists of India
- Past President—Mumbai Obstetric and Gynecological
- Society
- Jt. Secretary Indian Academy of Juvenile and
- Adolescent Gynecology and Obstetrics
- Member of Medical Education Committee Asia
- Oceana Federation of Obstetrics and Gynecology
- Secretary General, South Asian Federation of
- Obstetricians and Gynecologist
- CN Purandare MD MAO DO DGO DFP FICOG FICMCH
- Vice Dean (Overseas)
- Univ. of Seychelles American Institute of Medicine
- Ex. Hon. Prof. of Obs. & Gyn. GMC
- JJH Mumbai
- Sec. General FOGSI
- President MOGS 2003-04
- Jt. Associate Editor, Journal FOGSI
- K Krishnankutty MD DGO FICOG
- Consultant Obstetrician and Gynecologist
- Head of the Department
- KARE IVF Center Poonkunnam and West Fort
- HI-TECH Hospital Thrissur, Kerala
- NS Sreedevi MD DGO
- Professor and Head
- Dept. of Obs. and Gyn.
- Calicut Medical College
- Member International Society for Study of
- Trophoblastic Diseases
- Ajay Swaminathan MD (Obs. and Gyn.)
- BJ Medical College, Ahmedabad
- Ex. Senior Registrar in Gynecological Oncology
- MP Shah Cancer Hospital
- Ahmedabad
- Anandhi Arul MD DA FRCA
- Consultant Anesthetist, GKNM Hospital
- Coimbatore
- Tamil Nadu
- Aneesh Sabnis DNB FCPS DGO DFP
- Dip. Endoscopic Surgery (Germany)
- Consultant Gynecologist
- Obstetrician and Endoscopic Surgeon
- Sneh Nursing Home and Centre for
- Gynecological Endoscopic Surgery
- Andheri (E), Mumbai
- Consultant Gynecologist, GKNM Hospital, Gujarat
- Ariella Jakobson-Setton MD
- Dept. Obstetrics and Gynecology
- Sheba Medical Center, Tel-Hashomer, 52621,
- Affiliated with Tel-Aviv University, Israel
- Betsy Thomas MD DGO
- Assistant Professor
- Amala Medical College and Cancer Hospital
- Thrissur, Kerala
- Bhavin M Shah MD
- Chest Physician
- Parakh Hospital, Ghatkopar, Mumbai
- Bindu Sainath MD
- Associate Professor and Head of Unit
- Shri MP Shah Medical College and GG Hospital
- Jamnagar, Gujarat
- C Anand MCH (URO) NB (URO)
- Urologist, GKNM Hospital, Gujarat
- C Kumar DA
- Anesthesiologist, GKNM Hospital, Coimbatore
- Daniel S Seidman MD
- Dept. Obstetrics and Gynecology
- Sheba Medical Center, Tel-Hashomer, 52621,
- Affiliated with Tel-Aviv University, Israel.
- Deepika Gupta DNB
- Surgical Associate, Manchanda's Clinic
- 7 Ring Road, Lajpat Nagar IV, New Delhi
- Fessy Louis T DGO DNB MNSMS
- Consultant Gynecologist and IVF Co-ordinator
- CIMAR, Kerala
- Gayatri Thaker MD
- Consultant Obstetrician and Gynecologist
- Sidhi Vinayak Hospital, Nehru Road, Jamnagar
- President, SOGOG
- State Body of Gynecologists, Gujarat
- K Jayakrishnan MD DGO
- Director, KJK Hospital Fertility Research and
- Gyn. Centre Nalanchira, Trivandrum
- Karpagam Murali MD (Obs. & Gyn.)
- Consultant Gynecologist, GKNM Hospital, Coimbatore
- KA Sreenivasan MD DGO FCGP
- Formerly Deputy Director of Health Services of Kerala
- State Maternal and Child Health
- Associate Professor
- Dept. of Obstetrics and Gynecology
- Amala Institute of Medical Sciences
- Thrissur, Kerala
- KK Gopinathan MD DGO
- HOD and Director, CIMAR, IVF Centre
- Edappal, Kerala
- M Venugopal MD DNB
- Consultant Obstetrician and Gynecologist
- KARE Centre, Poonkunnam and
- West Fort HI-TECH Hospital, Thrissur, Kerala
- M Vinayachandran MD DGO
- Associate Professor
- Dept. of Obstetrics and Gynecology
- Calicut Medical College, Calicut, Kerala
- Mala Raj DGO
- Consultant, City Care Hospital
- Visiting Endoscopic Surgeon
- Port Trust Hospital, Chennai
- Neeta Mandhai MD (Obs. & Gyn.)
- Associate Professor and Head of Unit
- Dept. of Obstetrics and Gynecology
- Shri MP Shah Medical College
- Ex. Secretary, Jamnagar Obs. & Gyn. Society
- Gujarat
- Nikhil Purandare MBBS MCPS
- Resident Obstetrics and Gynecology
- University College Hospital, Galway
- Republic of Ireland
- Associate Professor of Medicine
- Shri MP Shah Medical College, Jamnagar, Gujarat
- Pai MS MCH (URO)
- Urologist
- GKNM Hospital, Gujarat
- PG Paul DGO
- Chairman, Paul's Hospital, Cochin
- Director, Cochin Gynecological Endoscopic
- Training Center, Chairperson of Clinical Research
- Committee of FOGSI (1998-2002)
- Elected to Membership of the Society of Reproductive
- Surgeons, American Society of Reproductive
- Medicine in 1997, (First Member from India)
- Reknowned Speaker and Teacher in Endoscopy.
- Published a book on Endoscopy
- Pragnesh Desai
- Practicing Gynecological Endoscopic Surgeon in
- Private and Medisurge Hospital, SAL and Apollo
- Hospital, Ahmedabad
- Hon. Secretary in Ahmedabad Obs. & Gyn. Society
- and State Obs and Gyn. Societies of Gujarat
- Reknowned speaker and teacher in Endoscopy
- Rahul Manchanda MD MICOG FICMCH
- Dip. Gyn. Endoscopy (Kiel, Germany)
- Fellowship Advanced Gyn. Endoscopy (France)
- Consultant Gynecological Endoscopic Surgeon
- Dr. Manchanda's Clinic
- 7 Ring Road, Lajpat Nagar IV, New Delhi
- Rajalaxmi Walavalkar MD DNB FCPS DGO DFP
- Specialist Registrar Obs. and Gyn.
- St Mary's Hospital, Portsmouth, UK
- Rajendra Sankpal MD DGO DNBE FCPS DFP
- Dip. Adv. Laparoscopy (USA) Dip. Adv Lap. Surg. (France)
- Fellowship 3D USG USA
- Chief Gynecologist and Endoscopic Surgeon
- Holyspirit Hospital, Mumbai
- Global Hospital and Research Center, Mumbai
- Rajini Sundar MD
- Chief Anesthetist, GKNM Hospital, Coimbatore
- Ramalingam MS McH (URO)
- Consultant Urologist, GKNM Hospital, Gujarat
- S Anandi MBBS DNB
- Consultant Gynecologist GKNM Hospital, Gujarat
- S Natarajan MD MNAMS DM
- Chief Cardiologist
- GKNM Hospital
- Coimbatore, Tamil Nadu
- Sachin K Ajmera MD DNB FCPS DGO DFP
- Dip. Endoscopic Surgery (Germany)
- Consultant Gynecologist
- Terna Hospital amd Research Centre, Navi Mumbai
- Sandhya Gupta DGO Dip. Advanced Endoscopic Surgery (Germany)
- Consultant Gynecologist
- Apollo Cradle Hospital, Lion's Kidney Hospital New Delhi
- Sathy M Pillai MD
- Chief Infertility/IVF Specialist, SAMAD IVF Hospitals
- Kollam, Attingal and Thiruvananthapuram, Kerala
- India First ISO Certified IVF Center in Kerala
- Shailaja Sabnis MD (Internal Medicine)
- Consultant Physician and Rheumatologist
- Sneh Nursing Home, Mumbai
- Shefalika MBBS DGO
- Assistant Medical Officer
- GKNM Hospital
- Coimbatore, Tamil Nadu
- Shobhana M MD DGO Dip. Endoscopic Surgery (Germany)
- Consultant Gynecologist and Endoscopic Surgeon
- Dept. of Infertility and Key Hole Surgery
- Elite Mission Hospital
- Thrissur, Kerala
- Chief Obstetrician and Gynecologist
- GKNM Hospital, Coimbatore
- Past President Coimbatore Obs. & Gyn. Society
- Suvarna Khadilkar MD DGO
- Associate Professor, GMC, JJ Hospital, Mumbai
- Jt. Asst. Secretary to Journal of Obs. and Gyn. India
- FOGSI, Chairperson, Reproductive Endocrinology
- Committee, MOGS
- T Schollmeyer
- Department of Obstetrics and Gynecology
- University Hospitals
- Schleswig-Holstein, Keil, Germany
- Vijay Sata MS (Orth)
- Associate Professor and Head of Unit
- Dept. of Ortho. Surgery
- Shri MP Shah Medical College
- Jamnagar, Gujarat
- VK Chellamma
- Associate Professor
- Dept. of Obstetrics and Gynecology
- Calicut Medical College Hospital
- Calicut, Kerala
- Umesh Gupta MS FACA
- Senior Vascular Surgeon
- Apollo Hospital, New Delhi
A long felt need for a book “Textbook on Complications in Gynecological Surgery” has been fulfilled by its editors Dr Shobhana M and Dr Aneesh Sabnis. The book gives precise information on various complications of conventional as well as keyhole gynecological surgeries, in addition to preoperative and postoperative management.
A well balanced selection of authors from India and abroad have contributed excellent information for post-graduate students, teachers and practicing gynecologists. I am sure the book will find a place in every gynecologist's library as a ready reckoner. The efforts by the editors Dr Shobhana M and Dr Aneesh Sabnis are highly appreciable, specially because of well conceived thoughts to bring out a book on an altogether different topic of great clinical interest in the field of obstetrics and gynecology.
I compliment them from the bottom of my heart. I have no hesitation in recommending this book to one and all in the field of obstetrics and gynecology.
Dr PK Shah
Prof. in Obstetrics and Gynecology
LTM Medical College and
LTM Hospital, Sion, Mumbai
10Preface
This book is meant to help the practicing gynecologic surgeon in avoiding potential complications and deal with them competently in the eventuality of encountering them. Quite often, when faced with an unusual twist of event, one may have to frantically search for opinions from colleagues or old friends or even scour the internet for possible solutions. If the situation is critical, there may be no time for such pursuits.
This book covers all the possible aspects of postoperative complications with no pretext being made to make it concise or point form. It is meant to provide all possible information to the surgeon in distress, being a guide to the surgeon dealing with unexplained postsurgical problems. Reading it from page to page may not be as rewarding, as finding a quick solution to a perplexing problem.
Authors from all over India and two from abroad have taken pains to cover all aspects of the postoperative period with ample examples being quoted from real life incidents. Coordinating more than 30 doctors from the length and breadth of the country being a daunting task, lacunae may have crept in, but I hope this book helps a few gynecologists and thereby help many patients have safer postoperative periods.
Shobhana M
11Acknowledgements
I acknowledge the efforts of
- All the national and two eminent international authors who have selflessly taken pains to complete the chapters in this book.
- My assistant editor, Dr Aneesh Sabnis has rendered invaluable support, both physical and moral.
- Dr Jayasree Menon and Dr Indu Menon, anesthetist colleagues at Elite Mission Hospital, where I work have given valuable suggestions, besides proofreading, the chapters, Dyspnea, Pulmonary Complications and Analgesia. Dr Thomas Kunnath has also given valuable suggestions.
- Dr Shailaja Sabnis, who has re-edited the chapter on Transfusion Reactions.
- Dr E Mohandas for helping in finding many references which were supplied to many of the contributors.
- My parents, children, brother and sister who are a great help by just being there.
- God almighty, for providing the tenacity to go on when the pace became painfully slow at times.
- I acknowledge to Shri JP Vij, Chairman and Managing Director of M/s Jaypee Brothers Medical Publishers Pvt. Ltd., for the publication of this book. I gratefully acknowledge the sincere efforts of Mr Tarun Duneja, General Manager (Publishing), Ms Anju Saxena, Ms Shilpi Dutta and Mr Neelambar Pant (Proofreaders), for ensuring a very high quality of the book and bringing it out in such a short-time.