Index

Operative Obstetrics and Gynecology Randhir Puri, Narendra Malhotra, Jaideep Malhotra, Pranay Shah

1: GENERAL
1:Historical Perspective–Last Five Decades
- INTRODUCTION
- SURGEON'S SKILL
- BASIC PILLARS OF SURGERY
  - Anesthesia
  - Blood Transfusion and Various Disposables
  - Prophylactic Antibiotics
  - Hemostasis
  - Sutures
  - Laparotomy
- CESAREAN SECTION
- FORCEPS DELIVERY AND VACUUM EXTRACTION
- CERVICAL TIGHTENING
- EPISIOTOMY
- DESTRUCTIVE OPERATIONS
- SYMPHYSIOTOMY
- VENTRISUSPENSION
- DIAGNOSTIC D AND C FOR INFERTILITY
- HYSTERECTOMY
  - Vaginal Hysterectomy
  - Abdominal Hysterectomy
  - Laparoscopic Hysterectomy
  - Alternatives to Hysterectomy
- FEMALE STERILIZATION
- MEDICAL TERMINATION OF PREGNANCY (MTP) OR VOLUNTARY STERILIZATION
- STRESS URINARY INCONTINENCE (SUI)
- GENITAL PROLAPSE
- TUBOPLASTY
- GYNECOLOGIC ONCOSURGERY
- ENDOSCOPIC SURGERY
  - Hysteroscopic Surgery
  - Laparoscopic Surgery
- CONSUMER PROTECTION ACT (CPA)
- SUMMARY
2:Future of Gynecological Surgery: Next Five Decades
- INTRODUCTION
- FUTURE DEVELOPMENTS
- TECHNOLOGICAL ADVANCES
- Virtual Reality Simulators and Robots
- CONCLUSIONS
3:General Care Principles in Surgery
- INTRODUCTION
- PREOPERATIVE CARE PRINCIPLES
- PREOPERATIVE EVALUATION
  - History and Physical Examination
- EXAMINATION
- LABORATORY INVESTIGATIONS
- INTRAOPERATIVE CARE PRINCIPLES
  - Principles of Asepsis
  - Surgical Technique
- POSTOPERATIVE MANAGEMENT
  - Objectives of Postoperative Management
- POSTOPERATIVE CARE
4:Intravenous Fluids, Blood Products and Transfusion
- INTRODUCTION
- PHYSIOLOGICAL CHANGES AND ADAPTATION DURING PREGNANCY
- BLOOD COMPONENT TRANSFUSION OBSTETRIC INTENSIVE CARE PATIENT
- CELLULAR COMPONENTS (TABLE-2)
  - Red Blood Cells
  - Platelet Concentrates
- PLASMA COMPONENTS (TABLE-3)
- ALTERNATIVES AND TECHNIQUES TO AVOID TRANSFUSION
- CONCLUSION
5:Incisions and Sutures
- TYPE OF INCISIONS (FIG. 1)
  - Paramedian (Fig. 2)
  - Lower Midline (Fig. 3)
- GROIN INCISION
- BASICS OF WOUND CLOSURE AND HEALING
- TISSUE RESPONSE TO INJURY
  - Surgical Skill Methods Facilitating Healing
  - Needles
- SUTURES (FIGS 6 TO 8)
- BASIC KNOT : ANATOMY AND METHODOLOGY
- COMMON TYING TECHNIQUES
- SMEAD-JONES/FAR-AND-NEAR
- CONCLUSION
6:Peri-operative Assessment and Drugs: Antibiotics, Analgesics, Others
- ANTIBIOTICS
- PSYCHOTROPIC DRUGS
- MONO-AMINE OXIDASE INHIBITORS (MAOIs)
- PHENOTHIAZINE DERIVATIVES
- LEVODOPA
- STEROID THERAPY
  - Antihyperglycemic Medications
  - Antihypertensive Medications
    - Hypertension
- ACE INHIBITORS
- CALCIUM CHANNEL BLOCKERS
- ANGINA PROPHYLAXIS DRUGS
- PRE-ECLAMPTIC PATIENT
- FIT FOR SURGERY
- ASSESSMENT OF PHYSICAL STATUS
  - ASA Classification
- CANCELING CASES
- PREOPERATIVE PREPARATION OF THE PATIENT IN THE HOSPITAL
- THE DAY OF OPERATION
- PREMEDICATION
- SUMMARY
7:Analgesia for Obstetrics and Postoperative Case Principles
- INHALATIONAL ANESTHETIC AGENTS
- INTRATHECAL (SPINAL) OPIOIDS
- LOCAL ANESTHETICS
- POSTOPERATIVE CARE
  - Routine Recovery
- PAIN CONTROL
- AGITATION
- NAUSEA AND VOMITING
- SHIVERING
8:Anesthesia for Obstetrics and Gynecology Surgery
- PREOPERATIVE PREPARATION OF THE PATIENT
- THE DAY OF OPERATION
- SUGGESTED ANESTHETIC PLAN
- PREMEDICATION
- MONITORING
  - General Anesthesia (GA)
    - Advantages of GA
    - Disadvantages of GA
  - Induction
  - Muscle Relaxants
  - Maintenance
  - Reversal
- REGIONAL ANESTHESIA
  - Advantages of Regional Anesthesia Over GA Are
  - Advantages of Spinal Over GA
  - Advantages of Spinal Over Epidural
  - Disadvantages of Spinal
  - Advantages of Epidural Block
    - With Epidural Catheter in Place
  - Disadvantages of Epidural
  - Combined Spinal-Epidural (CSE)
  - Contraindications of Regional Blocks
    - Absolute
    - Relative
  - Laparoscopy and Hysteroscopy
- ANESTHESIA FOR GYNECOLOGICAL LAPAROSCOPIC SURGERY
  - Physiologic Changes Related to Pneumoperitoneum
  - Respiratory System Changes
  - Patient Selection For Laparoscopic Surgery
  - Monitoring
    - Normal Monitoring
    - Cardiovascular Monitoring of High-risk Patients
  - CO2 Monitoring
  - Management of Anesthesia
  - Day Case Surgery
  - Local Anesthesia
  - Epidural Anesthesia
  - General Anesthesia
  - Lengthy Laparoscopic Procedures
  - Extraperitoneal Laparoscopic Surgery
- COMPLICATIONS
  - Gas Embolism
    - Mechanism
    - What To Do?
  - Cardiovascular Collapse
    - Etiology
  - Pneumothorax
- ANESTHESIA FOR HYSTEROSCOPY
  - Installation and Monitoring
  - Anesthetic Techniques
  - Complications
    - Nonspecific Complications
    - Specific Complications
- CONCLUSION
- REFERENCES
- VOLATILE INHALATIONAL AGENTS
  - Anesthetic Management of ART
  - Oocyte Retrieval
- EMBRYO TRANSFER
- POSTANESTHESIA CARE
- REFERENCES
  - Physiology and Risk Assessment
  - Anesthetic Management
  - Special Situations
- CONCLUSIONS
- REFERENCES
- GA FOR CESAREAN SECTION
- NEED FOR GA
- PREPARATION FOR GA
- PREDICTION OF DIFFICULT AIRWAY
  - Aspiration Prophylaxis
  - Pre-Oxygenation
  - Fetal Considerations
- UTERINE INCISION TO DELIVERY TIME
  - Conduct of GA
- REGIONAL ANESTHESIA FOR CESAREAN SECTION
  - Preoperative Preparation
  - Considerations During Surgery
    - Postoperative Care
    - Spinal
  - Extending the Duration of Spinal Anesthesia
  - Spinal Anesthesia Following Epidural Block
  - Combined Spinal – Epidural Anesthesia
  - Local Infiltration Anesthesia for Cesarean Section
- REFERENCES
9:Intraoperative Investigative Tools
- INTRODUCTION
10:Operation Theater Set up
- LOCATION AND LAY-OUT
- PROTECTIVE ZONE (A)
- CLEAN ZONE (B)
  - Emergency OT
- ASEPTIC ZONE OR STERILE ZONE (C)
- CONCLUSION
11:OT Protocols, Law and Administrative Requirement for Gynecological Surgeons
- INTRODUCTION
- MEDICINES
  - Emergency Medicines
  - Medicines for Routine Use
- EQUIPMENT
- FACILITIES
- CONCLUSION
12:Postoperative Complications
- INTRODUCTION
  - Choice of Anesthesia
  - Recovery Period
- EARLY COMPLICATIONS DURING PERIOPERATIVE PERIOD
  - Vital Signs Monitoring
- FLUID AND ELECTROLYTE IMBALANCE
  - Water Balance
  - Sepsis
- HEMORRHAGE
- PHLEBOTHROMBOSIS AND PULMONARY EMBOLISM
  - Superficial Thrombophlebitis
- WOUND COMPLICATIONS
- NEUROLOGICAL COMPLICATIONS
- FOREIGN BODIES
13:Postoperative Infections
- INTRODUCTION
- RISK FACTORS
- PATHOGENS
- THE VAGINAL ECOSYSTEM
- PREVENTION
- DIAGNOSIS AND TREATMENT
14:Sepsis in Obstetrics
- INTRODUCTION
- HISTORICAL PERSPECTIVE
- DEFINITION
- RECENT UNDERSTANDING OF SEPSIS AND ITS PATHOPHYSIOLOGY (FIG. 1)
  - Bacteriology of Sepsis
  - Predisposing Factors (Fig. 2)
- CLINICAL ASPECT OF SEPSIS
  - Effect of Shock on Individual Organs
- ASSESSMENT AND MANAGEMENT OF SEPSIS
- INVESTIGATIONS
- PRINCIPLES OF THERAPY
  - Universal Measures
- MEDICINES
- DEFINITIVE TREATMENT
- THE FUTURE OF SEPSIS MANAGEMENT
- CONCLUSION
  - Acknowledgment
15:Postoperative Nutrition
- INTRODUCTION
- EARLY POSTOPERATIVE NUTRITION
- METABOLIC CHANGES IN SURGICAL PATIENTS
- ENTERAL NUTRITION
- CONCLUSION
16:Physiotherapy in Postoperative Gynecological Surgery
- DEEP BREATHING EXERCISES
- PELVIC FLOOR MUSCLE EXERCISES
17:Grafts in Gynecological Surgery
- INTRODUCTION
- TVT POLYPROPYLENE TAPE
- CONCLUSION
2: OBSTETRICS
18:Labor Room Operative Procedures
- INTRODUCTION
- ARTIFICIAL RUPTURE OF MEMBRANES
- EPISIOTOMIES/PERINEOTOMY
- BLADDER CATHETERIZATION
- DILATATION AND EVACUATION (D AND E)
- SYMPHYSIOTOMY
19:Induction and Augmentation Labor
- INTRODUCTION
- INCIDENCE
- METHODS OF CERVICAL RIPENING AND INDUCTION OF LABOR
- A DISCUSSION ON THE RELATIVE MERITS OF PROSTAGLANDINS AND OXYToCIN FOR INDUCTION OF LABOR
- OTHER PHARMACOLOGICAL METHODS OF INDUCTION OF LABOR
20:Operative Principles of Fetal Malpositions and Malpresentations
21:Operative Delivery
- FORCEPS
- ANATOMY OF FORCEPS
- TECHNIQUE
  - Steps of Forceps Delivery
  - Complications
- ASSISTED VAGINAL DELIVERY USING THE VACUUM EXTRACTOR
- TYPES OF VACUUM EXTRACTORS
- VACUUM EXTRACTORS AND FORCEPS
- INDICATIONS AND CONTRAINDICATIONS FOR VACUUM EXTRACTION
- PROCEDURE USING SOFT-CUP VACUUM EXTRACTION
- MATERNAL AND FETAL COMPLICATIONS
  - Medicolegal Concerns
- CONCLUSION
22:Repair of Tears: Vaginal, Perineal and Cervical
- VAGINAL TEARS
- CERVICAL TEARS
23:Manual Removal of Placenta
- PHYSIOLOGY OF PLACENTAL SEPARATION
  - Schultze's Method
  - Mathew-Duncan Method
    - When the Placenta has Separated Fully Expulsion Occurs
    - Signs of Placental Separation
- INDICATIONS OF THE PROCEDURE
- RETENTION OF THE PLACENTA
  - Measures Instituted to Promote Delivery of Placenta
  - Types of Placental Retention
- ANESTHETIC TECHNIQUES
- CONCLUSION
24:Uterine Rupture, Scar Dehiscence, Uterine Inversion
- DIAGNOSIS
- REPAIR OF UTERUS
- COMPLICATIONS7
25:Postpartum Hemorrhage—Surgical Interventions
- INTRODUCTION
- DEFINITION
- MANAGEMENT OF POSTPARTUM HEMORRHAGE
- SURGICAL MANAGEMENT
  - Selective Arterial Embolization
  - Genital Tract Trauma
- LAPAROTOMY
- BLEEDING AT CESAREAN DELIVERY
- INTERNAL ILIAC, UTERINE ARTERY LIGATION DEVASCULARIzATION OF UTERUS
  - Uterine Artery Ligation
- VAGINAL TECHNIQUE OF UTERINE ARTERY LIGATION
  - Ovarian Artery Ligation
  - Internal Iliac (Hypogastric) Artery Ligation
- OBSTETRIC OR CESAREAN HYSTERECTOMY
- SUMMARY
26:Peripartum Hysterectomy
- INTRODUCTION
- INCIDENCE
- RISK FACTORS FOR PERIPARTUM HYSTERECTOMY
- INDICATIONS
- SURGICAL ANATOMY
- ANESTHETIC CONSIDERATIONS
- OPERATIVE STEPS
- SUBTOTAL (SUPRACERVICAL) HYSTERECTOMY
- TOTAL HYSTERECTOMY
- POSTOPERATIVE CARE
- COMPLICATIONS
  - Intraoperative Complications
  - Postoperative Complications
27:Bladder Injuries and Other Complications
- URETERAL INJURIES
- MANAGEMENT OF SPECIFIC INJURY TYPES
- PREVENTION OF URETERAL INJURY
- BLADDER INJURIES
- RARE FISTULAE
  - Vesico-uterine and Vesico-cervical Fistula
  - Urethro-vaginal Fistulae
28:Cesarean Section
- INTRODUCTION
- INDICATIONS
- CONCLUSIONS
29:Ectopic Pregnancy–Surgical Management
- INTRODUCTION
- CONCLUSION
30:Laparoscopy and Obstetrical Practice
- INDICATIONS FOR LAPAROSCOPIC SURGERY IN PREGNANCY
- TECHNICAL CONSIDERATIONS WHILE PERFORMING LAPAROSCOPY IN PREGNANCY
- FETAL RISKS OF LAPAROSCOPY IN PREGNANCY
- CONCLUSION
31:Prenatal Diagnostic Procedures
- CHORIONIC VILLUS SAMPLING
- AMNIOCENTESIS
- CORDOCENTESIS
32:Fetal Surgery
- INTRODUCTION
- EVOLUTION OF FETAL SURGERY
- PRINCIPLES OF FETAL SURGERY
- INDICATIONS
  - Urinary Tract Obstructive Defects
- URETEROPELVIC JUNCTION (UPJ) OBSTRUCTION
- URETEROVESICAL JUNCTION (UVJ) OBSTRUCTION
- URETHRAL OBSTRUCTION
  - Lung Defects
- SACROCOCCYGEAL TERATOMA (SCT)
  - TWIN TO TWIN TRANSFUSION SYNDROME (TTTS)
    - Fetal Surgery
- CONGENITAL DIAPHRAGMATIC HERNIA (CDH)
3: GYNECOLOGY
33:Perioperative Measures and Positioning the Patient, for Surgery
- LITHOTOMY POSITION (FIGS 3 AND 4)
  - Back and Pelvis
  - Legs (Figs 5 and 6)
- Conclusion
34:Suture and Choice with Abdominal Wall Closures
- INTRODUCTION
- RELEVANT ANATOMY
  - Blood Supply
  - Nerve Supply
- TYPES OF ABDOMINAL INCISIONS
- INCISIONS IN PATIENTS WHO ARE OBESE
- SUTURES
  - Absorbable Sutures
  - Nonabsorbable Sutures
35:Hemostasis and Drains
- INTRODUCTION
- ADVANTAGES AND DISADVANTAGES OF LASERS
- SURGICAL DRAINS
  - Wound Drainage
- TYPES OF DRAINS
  - A
  - B
- TYPES OF DRAINS AND THEIR USES
- LOW VACUUM DRAINAGE: HANDYVAC
  - Introduction
  - How to Use the Handyvac (Fig. 4)
36:Abortions
- Conclusion
- REFERENCES
- REFERENCES
37:Vulva
- SURGICAL TECHNIQUE STEPS
- THE HYMEN
  - Function of the Hymen
  - Types of Hymen (Figs 2A and B)
  - Causes for Tear
  - Virgin
  - Surgeon Restore Hymens for
  - Hymenorrhaphy, Hymenoplasty, or Hymen Restoration or Hymen Replacement Surgery or Restoration of the Hymenal Ring
  - Types of Surgery
- STEPS
  - The Simplest Technique of Hymenorrhaphy (surgical repair)
  - Stitch Across Hymen (Fig. 3)
  - A Gelatin Capsule
- THE DEFINITIVE PROCEDURE
  - Hymen Replacement Surgery
  - Alloplant for Hymenoplasty
- CONCLUSION
- BIBLIOGRAPHY
- INTRODUCTION
- SURGICAL ANATOMY
  - Epidemiology
  - Pathophysiology
- MANAGEMENT OF BARTHOLIN'S GLAND CYSTS
- ANESTHESIA
- POSITION, DRAPING
- EXCISION
  - Word Catheter Treatment (Figs 2 and 3)
  - Marsupialization (Figs 4 and 5)
- MANAGEMENT OF BARTHOLIN'S GLAND ABSCESSES
  - Bartholin's Gland cyst in Pregnancy
- COMPLICATIONS
  - Recurrence
- REFERENCES
- ALCOHOL INJECTION OF THE VULVA (Fig. 1)
  - Technique
- CORTISONE INJECTION OF THE VULVA
  - Technique
- INTRODUCTION
  - Preoperative Considerations
  - Primary Closure Technique
- INTRODUCTION
  - Types
- SURGICAL ANATOMY OF VULVA AND THE PERINEUM1
- ARTERIAL SUPPLY TO VULVA AND PERINEUM1,2
- NERVE SUPPLY OF VULVA AND PERINEUM
- THE LYMPHATIC DRAINAGE OF THE VULVA
  - Preoperative Investigations And Preparation
- ANESTHESIA AND POSITION
  - Indication
  - Procedure
- SIMPLE VULVECTOMY
  - Indication
  - Procedure
- RADICAL VULVECTOMY
  - Indication
  - When Lesion is Beyond the Vulva
- WIDE LOCAL EXCISION WITHOUT GROIN DISSECTION (FIG. 10)
  - Indication
- WIDE LOCAL EXCISION WITH GROIN DISSECTION
  - Indication
- MODIFIED RADICAL HEMIVULVECTOMY WITH IPSILATERAL GROIN DISSECTION14
  - Indication
- ANTERIOR RADICAL VULVECTOMY WITH BILATERAL GROIN DISSECTION
  - Indication
  - Posterior Radical Vulvectomy With Bilateral Groin Dissection
    - Indication
  - Total Radical Vulvectomy With Bilateral Groin Dissection
    - Indication
- TECHNIQUE OF EN BLOC RADICAL VULVECTOMY
- RADICAL VULVECTOMY WITH TRIPLE INCISION7
  - Post Operative Complications and Management
  - Late Complications
- CONCLUSION
- ACKNOWLEDGMENTS
- REFERENCES
- SOLID BENIGN TUMORS OF VULVA
- CONDYLOMA ACUMINATUM
- HIDRADENOMA OF VULVA
- VULVAR INTRAEPITHELIAL NEOPLASM
- CANCER OF THE VULVA
- TNM CATEGORY/FIGO STAGE
  - Primary Tumor (T)
  - Regional Lymph Nodes (N)
  - Distant Metastasis (M)
  - Survival
- PRINCIPLES OF MANAGEMENT
  - Stage 0 (Carcinoma in situ)
  - Recurrent Vulvar Cancer
    - Case 1
    - Case 2
- REFERENCES
38:Vagina
- EMBRYOLOGY OF VAGINA
  - Stage I
  - Stage 2
  - Stage 3
  - Stage 4
  - Stage 5
  - American Fertility Society Classification of Mullerian Anomalies:
  - Transverse Vaginal Septum
  - Etiology
  - Clinical Presentation
  - Investigations
  - Treatment
- BIBLIOGRAPHY
- SURGICAL ANATOMY OF VAGINA (FIG. 1)
- VAGINECTOMY
  - Preoperative Preparation
- ANESTHESIA
- VAGINAL VAGINECTOMY
- COMPLICATIONS
- VAGINECTOMY WITH UTERUS IN SITU
- ABDOMINAL VAGINECTOMY
  - Complications
- VAGINAL STENOTIC RELEASE SURGERY
  - Perineotomy
- INCISION OF THE RING OR RIDGE
- ‘Z’-PLASTY
  - Vaginal Flap Advancement
  - Free Skin Graft
- REFERENCES
- INTRODUCTION
- ANATOMY AND PATHOLOGY
- THEORIES OF ANTERIOR VAGINAL WALL PROLAPSE
  - Evidence Till Date
  - Diagnostic Tests
  - Recent Advances in Pelvic Imaging
- PREOPERATIVE PREPARATION
- INDICATIONS
- POSITION, DRAPINGS AND INCISION
- STEPS OF OPERATION
- POSTOPERATIVE MANAGEMENT
- OTHER INNOVATIVE PROCEDURES
  - Anterior Colporrhaphy with Graft Augmentation
  - Vaginal Paravaginal Repair With and Without Graft Augmentation (Figs 6A to D)
  - Transobturator Tension-free Vaginal Mesh Techniques for Anterior Vaginal Wall Prolapse
- INTRAOPERATIVE COMPLICATIONS
- REFERENCES
- INTRODUCTION
- SURGICAL ANATOMY
  - Preoperative Assessment
  - Preoperative Treatment
  - Indications
- ANESTHESIA
- SURGICAL STEPS
- COMPLICATIONS
- GOODALL-POWER MODIFICATION OF LEFORT OPERATION
- CONCLUSION
- BIBLIOGRAPHY
- INTRODUCTION
- SURGICAL ANATOMY
  - Etiology
- CLASSIFICATION
  - Symptoms
  - Preoperative Assessment and Preparation
  - In Cases of Suspected Fistula but not Identified
  - Management
  - Approach
  - Timing
  - Preparation of the Patient
  - Routes of Repair
  - Radiation Fistula
  - Postoperative Care
  - Complications
    - I. Immediate
    - II. Delayed
- URETHROVAGINAL FISTULA
  - Surgical Anatomy5
  - Symptoms
  - Examination
  - Investigations
  - Preoperative Preparation
  - Therapeutic Options
    - Surgical Intervention
  - Low Fistula
  - Symmonds Technique7 (Figs 15 to 18)
  - Repair of Segmental Loss of Urethra (Figs 19 to 21)
  - Total/partial Urethral Loss
  - Dennis Browne (Modified by Chassar Moir 1964):9
  - Abdominal Approach9
  - Postoperative Care
  - Subsequent Care
  - Complications
    - Intraoperative
  - Postoperative
- CONCLUSION
- REFERENCES
- INTRODUCTION
  - Surgical Anatomy
  - Indications of Surgery
  - Preoperative Evaluation
  - Investigations
  - Different Approaches to Construct Vagina
  - Nonsurgical Methods
  - Surgical Methods
  - Postoperative Care
  - Complications
- CONCLUSION
- REFERENCES
- INTRODUCTION/PREOPERATIVE CONSIDERATIONS
- VAGINAL PROCEDURE TO SUSPEND THE VAGINAL APEX
  - Sacrospinous Ligament Fixation Surgical Anatomy
  - Steps of Operation (Figs 1 to 11)
- RESULTS
  - Complications
- ILIOCOCCYGEUS FASCIA SUSPENSION
  - Steps
- ABDOMINAL SACRAL COLPOPEXY
  - Position of Patient
- STEPS
  - Complications
- HIGH UTEROSACRAL LIGAMENT SUSPENSION
  - Laparoscopic Approach
- OBLITERATIVE PROCEDURES
  - Le Fort Partial Colpocleisis
  - Steps
- DEFINITION
  - What is Prolapse ?
  - Types of Prolapse
  - Anterior Vaginal Wall Prolapse
  - Postvaginal Wall Prolapse
  - Uterine Prolapse
  - Vault Prolapse7
  - Supports of Uterus
  - Etiology of Vault Prolapse
  - Immediate Post Surgery
  - Delayed Causes
  - Predisposing Factors of UV Prolapse and Vault Prolapse
  - Activating Factors
  - Identification of Apex of Vagina in Vault Prolapse
  - Prevention of UV Prolapse
  - Clinical Manifestations of Vault Prolapse
  - Management of Vault Prolapse
  - Surgical
    - Abdominal Sling Operation
    - Operations
  - Complications
- CONCLUSION
- REFERENCES
39:Cervix
- INTRODUCTION
- ANATOMY
- PREOPERATIVE PREPARATION
  - Indication
  - Anesthesia
  - Position
  - Types of Cervical Biopsy
  - Choice of Biopsy
  - Technique
- PUNCH BIOPSY
- WEDGE BIOPSY
- CONE BIOPSY
  - Indication
  - Cold Knife Excision
  - Laser Conization
  - Postoperative Complications
  - Cold Knife vs LLETZ vs Laser
  - Postoperative Care and Counseling
  - Collection and Fixing
  - Sections
    - Cone Biopsy
- ENDOCERVICAL CURETTAGE
  - Indication
  - Technique
- CONCLUSION
- REFERENCES
- COLD KNIFE CONIZATION
  - Loop Electrosurgical Excision
  - “See and Treat”
  - Morbidity
- BIBLIOGRAPHY
- INTRODUCTION
- INCIDENCE
  - Diagnosis
  - Indication/timing for Cerclage Placement
- ROLE OF ULTRASONOGRAPHY
  - Indications for cerclage
  - Contraindications
  - Risks of Cerclage
- PROCEDURES/OPERATIVE TECHNIQUE
  - Three Types of Suturing
- McDONALD'S PROCEDURE
- THE FOLLOWING ARE STEPS OF THE MCDONALD PROCEDURE
- SHIRODKAR PROCEDURE
- ABDOMINAL CERCLAGE
- LAPAROSCOPIC CERVICO-ISTHEMIC CERCLAGE
  - Wurm Procedure
  - Emergency Cerclage
  - Cerclage Removal
  - Conclusion and Recommendations
- REFERENCES
- INTRODUCTION
- FOTHERGILL'S REPAIR
- FOTHERGILL'S REPAIR
  - Preoperative Steps
    - Main Objectives
    - Operative Steps
  - Closure
  - Postoperative Care
  - Remote Complications
  - Outcome Measures
  - Place of Fothergill's Repair in Modern Management of Prolapse
- REFERENCES
- ANESTHESIA
  - Procedure/Steps
  - Suture
  - Alternative Techniques
  - Postoperative Care
  - Complications
- REFERENCES
- INTRODUCTION
  - Cryogen
- PHYSICS OF CRYOTHERAPY
  - Indications
  - Other Uses
  - Procedure of Cryosurgery
  - Pathophysiology
  - Followup of Cryosurgery
  - After Care Instructions
  - Complications
  - Advantages
  - Disadvantages
  - Place of Cryotherapy Today
- REFERENCES
- INTRODUCTION
  - Indications1
- ANESTHESIA2
  - Paracervical Block
- TYPES OF CERVICAL DILATATION3
  - Patient Preparation and Operative Procedure1,4
- DIFFICULTIES IN PERFORMING THE DILATATION1
  - Inability to Pass a Sound or Dilator
  - Point of Caution
  - Complications of dilatation1
- CONCLUSION
- ENDOCERVICAL CURETTAGE
  - Indications5
  - Procedure6
- REFERENCES
- PAP SMEAR
  - Technique
- APPLICATION OF PAP SMEAR
  - Screening for Cervical Cancer
  - Diagnostic Cytology – (Cervix, Uterus, Vagina and Vulva)
    - Samples
  - Reporting Pap Smear
    - New Bethesda System—Classification of Smears (2002)
  - Basis of Cytologic Reports
  - Growth Patterns
  - Abnormal Pap Smear Natural Progression and Regression
  - Adenocarcinoma In Situ
  - Endometrial Cancer
  - Extra Uterine Tumors
  - Lesion of Vagina and Vulva
  - Vaginal Vault Smear
  - Iatrogenic Changes
- HORMONAL CYTOLOGY
- SEX CHROMATIN (BARR BODY)
- Various Colposcopic Findings and Patterns (Figs 6 to 14)
  - Fluid Aspiration Cytology
- FINE NEEDLE ASPIRATION CYTOLOGY
  - Ovary
- REFERENCES
40:Tubes and Ovaries
- INTRODUCTION
  - Clinical Presentation
  - Sites of Ectopic Pregnancies (Fig. 2)
    - Risk Factors
  - Weaker Evidence for Association
  - Diagnosis
  - Tests to Help Diagnosis
- ULTRASONOGRAPHY
  - Other Modalities
  - Management
- SURGICAL MANAGEMENT
  - Laparoscopy
  - Salpingostomy
  - Salpingotomy
  - Role of Anti-D Prophylaxis
  - Special Conditions
    - Broad Ligament Ectopic Pregnancy
    - Chronic Ectopic Pregnancy
  - Interstitial Intrauterine Pregnancy (Fig. 4)
  - Rudimentary Horn (Cornual Extra Uterine Pregnancy) Ectopic Pregnancy
  - Ovarian Pregnancy
    - Abdominal Pregnancy
    - Bilateral Ectopic Pregnancy
  - Hetero Tropic Pregnancy (Combined Intra-and Extra-Uterine Pregnancies)
  - Cervical Ectopic pregnancy
  - Conclusion
- REFERENCES
- INTRODUCTION AND SURGICAL ANATOMY
- SALPINGECTOMY
  - Definition
  - Indications
  - Diagnosis
  - Anesthesia
  - Procedure (Laparotomy)2
  - Laparoscopic Salpingectomy3
  - Complications
- LINEAR SALPINGOSTOMY
- STEPS OF OPERATION
  - Risks
  - Alternatives
  - Dilemmas in Approach and Choice of Surgery
    - Laparotomy Vs Laparoscopic7 Approach
  - Salpingectomy/Salpingostomy7
- REFERENCES
- INTRODUCTION
- DEFINITIONS
  - Cystectomy
  - Ovariotomy
  - Salpingo-Oophorectomy
  - Radical Oophorectomy
- ANATOMY
- RELATIONS
- CHANGES WITH AGE
  - Infancy and Childhood
  - Menopause
- BLOOD SUPPLY
- LYMPHATIC DRAINAGE
- NERVE SUPPLY
- SALPINGO-OOPHORECTOMY
- PROCEDURE
- SALPINGO-OOPHORECTOMY FOR CHRONIC SALPINGITIS
- PARADOXICAL OOPHORECTOMY
- COMPLICATIONS AND POST-OPERATIVE CONSIDERATIONS
  - HRT After Salpingo-oophorectomy
  - Ovarian Remnant Syndrome
  - Residual Ovary Syndrome
- REFERENCES
- COUNSELING
- SELECTION OF CASES
  - Contraindication (Table 1)
- TIMING OF TUBAL LIGATION
- METHODS OF TUBAL STERILIZATION
- ABDOMINAL TUBECTOMY
  - Methods of Abdominal Tubectomy
  - Conventional Laparotomy
  - Minilaparotomy
- VAGINAL TUBECTOMY
  - Complications of Tubectomy
- LAPAROSCOPIC STERILIZATION
- POST LIGATION SYNDROME
  - Failure Rate
  - Mortality Following Tubal Sterilization
  - Tubal Ligation Versus Laparoscopic Sterilization
  - Sterilization In A Camp Set Up
  - Reversibility
  - Author's Experience and Opinions
- BIBLIOGRAPHY
- INTRODUCTION
  - Historical Perspective
  - Operative Procedure (Historical)1-3 (Figs 2A to E)
  - Laparoscopic Ovarian Drilling-Option Today
    - Mechanism of Action
- TECHNIQUES OF OVARIAN DRILLING (FIG. 3)
  - Electrocautary
  - Laser Drilling (Fig. 4)
  - Transvaginal Hydrolaparoscopy
  - Complications of Laparoscopic Drilling
- CONCLUSION
- REFERENCES
- LAPAROTOMY FOR OVARIAN CYSTECTOMY STEPS OF OPERATION
  - Abdominal Entry
  - Exploration of the Abdomen
  - Extraction of the Enlarged Ovary
  - Cystectomy (Figs 1A and B)
- LAPAROSCOPIC OVARIAN CYSTECTOMY
- REMOVAL OF A RETROPERITONEAL CYST
  - Dangers are Injuries to:
- REFERENCES
- INTRODUCTION
  - Principles of Microsurgery
  - Following are Essential for Success of Surgery
- INSTRUMENTS
  - Operating Microscope
  - Features of Operating Microscopes
  - Tubal Surgery is Traditionally Done by Laparotomy Route
- METHODS FOR TUBAL PATENCY INVESTIGATIONS
- COUNSELING AND CONTRAINDICATIONS
- CONTRAINDICATIONS
  - Relative Contraindications
    - Tubal Destruction following sterilization
- PREOPERATIVE EVALUATION OF COUPLES
- STEPS OF OPERATION
  - No Packs Or Retractors Used
  - Pregnancy Outcome
  - Incising the Adhesions
- FIMBRIOPLASTY
  - Releasing the Fimbriae
  - Salpingostomy/salpingoneostomy
  - Technique
    - Principles of the Procedure
- FREEING THE TUBE FROM OVARY
- CREATION OF NEW STOMA
- EVERSION OF FIMBRIAE
- VARIATION IN TECHNIQUE
  - Linear Salpingostomy
- PROSTHETIC DEVICES
- CONCLUSIONS
- REFERENCES
41:Uterus
- INTRODUCTION
  - Preoperative Preparation and Tests
- ANESTHESIA
  - Procedure
  - Complications
  - Ketamine Anesthesia
  - Complications
  - Short GA
  - Procedures
  - Complications
- REFERENCES
- INTRODUCTION
- SURGICAL ANATOMY (FIG. 1)
  - MVA (Fig. 2)
  - Advantages Over Electrical Vacuum Aspiration
- PREOPERATIVE PREPARATION AND PREOPERATIVE TESTS
  - Careful History Taking
- CAREFUL GENERAL EXAMINATION AND SYSTEMIC EXAMINATIONS
  - Careful Bimanual Examination
  - Laboratory Tests
  - Ultrasonography
  - Information and Counseling
  - Instruments and Supplies For Manual Vacuum Aspiration (MVA)
- INDICATIONS
  - On Medical Ground
  - On Eugenic Ground
  - On Humanitarian Ground
  - On Socio-Economic Ground
  - Preoperative Orders
- POSITION, DRAPING
- ANESTHESIA
- OPERATIVE STEPS
  - Postoperative Order
- COMPLICATIONS
  - Uterine Perforation
  - Hemorrhage
  - Incomplete Abortion
  - Infection
  - Continuation of Pregnancy or Failure of MVA
  - Long Term Complications
  - Other Uses of MVA (Manual Vacuum Aspiration)
- CONCLUSION
- ACKNOWLEDGMENT
- REFERENCES
- REFERENCES
- HISTORY
- TYPES OF RADICAL HYSTERECTOMY
- ADVANTAGES RADICAL SURGERY Vs RADIATION
- DISADVANTAGES
- INDICATIONS OF RADICAL HYSTERECTOMY
- CONTRAINDICATIONS
- RELEVANT ANATOMY
- PREOPERATIVE EVALUATION
- PREREQUISITES
- TECHNIQUE: STEPS OF OPERATION
- POSTOPERATIVE MANAGEMENT
- FOLLOW-UP
- COMPLICATIONS
- POSTOPERATIVE EXTERNAL RADIATION
- MODIFICATIONS
  - Okabayashi Method
  - Tokyo Method
  - Miami Method
- MORBIDITY AND MORTALITY OF RADICAL HYSTERECTOMY
- REFERENCES
- INTRODUCTION
- ASPECTS THAT COMPEL TO OPT VAGINAL HYSTERECTOMY
  - Complications
  - Time and Cost
  - Stay
  - Recovery
  - Blood Transfusion
  - Invasion
  - Morbidity
  - Randomized Studies
    - Scar
  - Quality of Life and Satisfaction
- CONTRAINDICATIONS
  - Common
  - Uncommon
  - EXCUSES
- INDICATIONS/ASSOCIATED CONDITIONS
  - Dysfunctional Uterine Bleeding (DUB)/Adenomyosis
  - Fibroids
  - Malignancy
  - Associated Obesity
    - Following should never deter gynecologist in taking vaginal route as primary route for hysterectomy
    - Following can persuade reluctant operator to take vaginal as primary route
- WHAT CAN PROMOTE VH AS PRIMARY ROUTE
  - Examination under anesthesia (EUA)
  - Trial Vaginal Hysterectomy
  - Laparoscopic Evaluation
  - Preoperative Uterine Volume
- DISCUSSION
- REFERENCES
- THE TEN STEP VAGINAL HYSTERECTOMY
- METHOD DESCRIPTION
  - Incision of the Vaginal Wall
    - In a Patient with a Prolapse
    - In a Patient without Prolapse
  - Detaching the Bladder From the Uterus
  - Opening Posterior Peritoneum
  - Dissection of the Lower Part of the Uterus
  - Cutting and Ligating the Uterine Arteries
  - Opening the Anterior Peritoneum
  - Dissection of the Upper Part of the Uterus (And Appendages)
- THE “NON STAGE”—LEAVING THE PERITONEUM OPEN
  - Reconstruction of the Pelvic Floor
  - Closing the Vaginal Wall
  - Discussion
- REFERENCES
- CONCLUSION
- REFERENCES
- REFERENCES
42:Laparoscopy
- ADVANTAGES
- DISADVANTAGES
- INDICATIONS FOR LAPAROSCOPY
  - Diagnostic Laparoscopy
    - Non-acute Conditions
    - Acute conditions
  - Operative Laparoscopy
- CONTRAiNDICATIONS TO LAPAROSCOPY
  - Absolute
  - Relative
- INSTRUMENTATION
  - Documentation Equipment
  - Insufflation Equipment
  - Accessory Instruments
    - Trocars
  - Ancillary Instruments
  - Suturing Techniques
  - Clark's Knot Tier
  - Staplers/Endoclips
  - CCL Vaginal Extractor
  - Electromechanical Morcellator
  - Electrosurgical Units
  - Unipolar Electrocoagulation
  - Bipolar Electrocoagulation
  - Harmonic Scalpel
- TECHNIQUES OF LAPAROSCOPY
  - Primary Trocar Entry
  - Veress Needle Insertion
    - CO2 Insufflation
  - Primary Trocar Insertion
- DIAGNOSTIC LAPAROSCOPY
- OPERATIVE LAPAROSCOPY
- COMPLICATIONS IN LAPAROSCOPY
  - Endoscopic Surgery Team
- INTRODUCTION
- INDICATIONS
  - Preoperative Preparation and Tests
  - One Day Bowel Preparation
  - Immediate Preoperative Preparation
  - Risk Factors
  - Anesthetic Risk Factors
  - Anesthesia
    - Spinal Anesthesia is Avoided Because
  - Surgical Anatomy
  - Position
  - Laparoscopic Access
  - Techniques of Primary Access
  - Direct Trocar Insertion
  - Open Laparoscopy
  - Expanding Access Cannulas
  - Sites of Veress Placement
    - Alternative Sites
  - Insertion of Veress Needle
  - Tests to Confirm the Proper Position of the Veress Needle (Fig. 3)
  - Troubleshooting Tip
  - Introduction of the Principal Trocar
  - Successful Trocar Insertion Depends on
  - Introduction of the Telescope
  - Introduction of the Ancillary Instruments
  - Pelvic Exploration
  - Removal of Instruments and Abdominal Closure
  - Complications and Management
  - Management
- RETROPERITONEAL MAJOR VESSEL INJURY
  - Signs and Management
- ABDOMINAL WALL VESSEL INJURY
  - Prevention
  - Management
- INTESTINAL INJURY
  - Prevention
  - Prevention
- BLADDER INJURIES
  - Intraoperative Signs
  - Postoperative Signs
  - Treatment
- URETERIC INJURIES
  - Symptoms
  - Prevention
  - Management
- CONCLUSION
- BIBLIOGRAPHY
- INTRODUCTION
  - Adhesion Formation
  - Postoperative Adhesion Formation
  - Laparoscopic Adhesiolysis – Technique
  - Adhesion Prevention — The Value of Adjuvants
  - Second Look Laparoscopy
- CONCLUSION
- INTRODUCTION
  - Laparoscopy for the Diagnosis of Endometriosis
- DIAGNOSTIC FINDINGS CONDITIONS ON LAPAROSCOPY
  - Operative Laparoscopy in Endometriosis
  - Surgical Treatment of Pain Associated with Endometriosis
  - Surgical Treatment for Endometriosis Associated Infertility
  - Laparoscopy for Endometriosis in Women of Reproductive Age
  - Laparoscopic Cystectomy
  - Laparoscopic Helium Plasma Coagulation (Helica)
  - Prognosis of Endometriosis
- CONCLUSIONS
- REFERENCES
- CONCLUSION
- BIBLIOGRAPHY
- INTRODUCTION
- INDICATIONS
- SURGICAL ANATOMY
- PREOPERATIVE PREPARATION AND SPECIAL PREOPERATIVE TEST
- MEDICAL PREPARATION
- POSITION, DRAPING AND INCISION
- ANESTHESIA
- OPERATIVE STEPS
  - Incision
- SURGICAL TECHNIQUES
- DISENGAGING THE LEIOMYOMA
- MANAGING THE OPERATIVE DEFECT
- REMOVING THE MYOMA
  - Technique
- COMPLICATIONS
- CONCLUSION
- BIBLIOGRAPHY
- CONCLUSION
- REFERENCES
- INTRODUCTION
- A PRACTICAL APPROACH TO OVULATION INDUCTION
  - Calculation of Thermal Energy
  - Threshold Dose
  - Plateau Dose
  - Excessive Thermal Energy
  - Depth of Penetration of Energy
  - Postoperative Monitoring
- PATHOPHYSIOLOGY OF PCOD
- MECHANISM OF ACTION OF “LEOS” IN OVARIAN OVULATION INDUCTION
  - Possible Mechanisms
- OUTCOME ANALYSIS OF LEOS
- PREDICTIVE FACTORS OF LEOS
- FACTORS INFLUENCING POSTOPERATIVE OVULATION INDUCTION AFTER TREATMENT WITH LEOS
- ADVANTAGES OF LEOS
- COMPLICATIONS
  - Adhesion Formation
  - Adjuvants for Adhesion Reduction
- OTHER COMPLICATIONS59
  - Ovarian Atrophy
  - Abortion Rates
  - Hyperprolactinemia
- CONCLUSION
- REFERENCES
- INTRODUCTION
  - History of the Procedure:2,3
  - Evolution of Family Planning Program in India
  - Timing of the Female Sterilization Procedure7-9
- TECHNIQUES OF STERILIZATION
  - Laparoscopic Sterilization
  - Follow up
  - Instruments Used for Laparoscopic Sterilization10,12,14,15
  - Anesthesia
  - Pre-operative Instructions
  - Procedure11,12,14-17
  - Clips
  - Complications (Tables 1 and 2)
  - Selection of cases — Govt of India Guidelines for Sterilization (Table 3)14,15,28
    - Eligibility Criteria for Sterilization
  - Assure Voluntarism
  - Medical Eligibility Check List
- CONCLUSION
- REFERENCES
43:Hysteroscopy
- CONTRAINDICATIONS
- EQUIPMENT FOR HYSTEROSCOPY
  - Telescope and Sheath
  - Operative Hysteroscope
  - The Resectoscope (Figs 3A and B) Has Five Parts
- ANCILLARY EQUIPMENT
- DISTENtION MEDIA
  - The Media Are of Two Types
    - Gaseous
    - Liquid
- FLUID DELIVERY SYSTEMS
- TECHNIQUE OF HYSTEROSCOPY
- Components of Hysteroscopy
  - The Hysteroscope
    - The Bettochi Hysteroscope: (Karl Storz)
    - The Versascope System (Johnson and Johnson)
  - Light Source
  - Endoscopic Camera and Monitor
- DISTENTION SYSTEMS
  - Carbon Dioxide
    - Fluid Distention Media
  - Distention Machines
- ENERGY SOURCES
  - Mechanical Energy
  - Unipolar
  - Bipolar Versapoint
- DIAGNOSTIC HYSTEROSCOPY
  - Operative Hysteroscopy
- COMPLICATIONS OF HYSTEROSCOPY
  - Distention Media
    - Liquids
    - Surgical
  - Traumatic Injuries of the Uterine Cervix and Corpus
  - Incidence of Complications
- INTRODUCTION
  - Diagnostic Indications
  - Therapeutic Indications
- HYSTEROSCOPY IN AN OFFICE SETTING
  - Contraindications
  - Premedications
  - Cervical Preparation
  - Complications
- HYSTEROSCOPY IN AN OPERATION THEATER SETTING
  - Operative Resectoscopy
- DISCUSSION
  - Asherman's Syndrome
  - Grade/Extent of Intrauterine Adhesions
- FALLOPIAN TUBE CANNULATION AND RECANALIZATION
  - Advantages
- UTERINE SEPTUM RESECTION
  - Advantages of Hysteroscopy
  - Submucous Myoma
  - Preoperative Diagnostic Assessment
  - Resection of Submucous Fibroids
- ADENOMATOUS POLYPS
  - Stenosed Cervical Canal
  - IVF and Embryo Transfer
- CONCLUSION
- BIBLIOGRAPHY
- INTRODUCTION
- SURGICAL ANATOMY
  - Endometrial Polyps
  - Fibroids
  - Thickness of the Uterine Wall1
- PREOPERATIVE PREPARATION
  - IMAGING STUDIES
  - ANTIBIOTIC PROPHYLAXIS
  - DIFFICULTIES
    - Cervical Stenosis
    - Large Uterus
  - Preoperative Medications to Reduce the Size of Fibroids
- CONTRAINDICATIONS
- CONCERNS FOR HYSTEROSCOPY IN SPECIFIC SITUATIONS
- INTRAOPERATIVE DETAILS
  - Anesthesia
  - Positioning
  - Hemostasis
  - Bladder Catheterization
  - Examination Under Anesthesia
  - Cervical Dilation
  - Visualization of the Uterine Cavity
  - Techniques
  - Monopolar Cautery
  - Bipolar Cautery
  - Laser
  - Distention Media
  - Technique (Figs 12 to 14)
  - Newer Developments
- POSTOPERATIVE DETAILS
  - General Care
  - Special Care
- COMPLICATIONS
  - Mechanical Complications
  - Media-related Complications
  - Bleeding
  - Infection
- CONCLUSION
- REFERENCES
- INTRODUCTION
- PATHOPHYSIOLOGY OF PROXIMAL TUBAL OCCLUSION
  - Diagnosis of Proximal Tubal Occlusion
  - Tubal Cannulation
  - Hysteroscopic Cannulation
  - Technique
  - Complications and Contraindications
- CONCLUSION
- REFERENCES
44:Bladder, Urethra and Incontinent Surgery
- INTRODUCTION
- THE PUBOVAGINAL SLING OPERATION FOR STRESS INCONTINENCE
  - Surgical Anatomy
- PREOPERATIVE EVALUATION
- INDICATIONS
  - Technique
- COMPLICATIONS AND THEIR MANAGEMENT
- BLADDER BUTTRESS OPERATIONS
- RETROPUBIC OPERATIONS
- BLADDER NECK SUSPENSION
- PERIURETHRAL INJECTIONS
- ARTIFICIAL URINARY SPHINCTER
- FACTORS INFLUENCING THERAPY
- OCCULT URINARY INCONTINENCE
- MIXED URINARY INCONTINENCE
- RECURRENT STRESS URINARY INCONTINENCE
- STRESS INCONTINENCE SURGERY COMBINED WITH OTHER PELVIC SURGERY
45:Small Bowel, Colon, Appendix in Gynecological Surgery
- INTRODUCTION
  - GI Conditions Simulating Gynecologic Conditions
- DIVERTICULITIS
- APPENDICITIS
- MECKEL'S DIVERTICULUM
- VOLVULUS
  - Pelvic Malignancies
  - Inflammatory Bowel Disease
- GYNECOLOGIC CONDITIONS THAT AFFECT THE GASTROINTESTINAL TRACT
  - Preoperative Bowel Prep
  - Positioning the Patient
- INTRAOPERATIVE CONSIDERATIONS
- RADIATION INJURY
- POSTOPERATIVE CONSIDERATIONS
- SURGERY ON THE SMALL INTESTINE
- SURGERY ON THE LARGE INTESTINE
- COLOSTOMY
46:Gynecologic Cancer Surgery
- SURGICAL MANAGEMENT OF CANCER CERVIX
- SURGICAL TREATMENT OF MALIGNANT OVARIAN NEOPLASMS
- SURGICAL MANAGEMENT OF CARCINOMA VULVA
  - Complications of Radical Vulvectomy and Bilateral Inguinal Lymphadenectomy
  - Surgery for Cancer Vagina
- PELVIC EXENTERATION
- LAPAROSCOPIC SURGERY IN ONCOLOGY
47:Surgery for Ovarian Cancer
- DIAGNOSIS AND STAGING
- BIBLIOGRAPHY
- INTRODUCTION
- INDICATIONS FOR PARA-AORTIC NODE DISSECTION
48:Omentectomy, J Flap, TRAM Flap
49:Role of Colposcopy in Gynecology
- NATURAL HISTORY OF CERVICAL CANCER
- ROLE OF HPV IN THE CAUSATION OF CERVICAL CANCER
  - Type of HPV virus
- PREVALENCE
- CYTOLOGY
- COLPOSCOPIC EVALUATION
- MANAGEMENT OF WOMEN WITH ABNORMAL CYTOLOGY
- NEWER DEVELOPMENTS IN COLPOSCOPY
- CONCLUSION
- BIBLIOGRAPHY
50:Overview of Assisted Reproductive Technologies Procedures
- INTRODUCTION
- HISTORY
- ASSESSMENT OF OVARIAN RESERVE
- OVARIAN STIMULATION
  - Clomiphene
  - Gonadotropins
  - GnRH analogues (Agonists)
- MAIN TREATMENTS MODALITIES
- IVF-ET (IN VITRO FERTILIZATION AND EMBRYO TRANSFER)
  - Ovarian Stimulation–Oocyte Retrieval
  - Oocyte Screening
  - Sperm Preparation (Fig. 2)
  - Oocyte Insemination
  - Fertilization Check-Day 1
  - Cleavage-Day 2
- ICSI (INTRACYTOPLASMIC SPERM INJECTION)
  - Indications
- OOCYTE RETRIEVAL (FIG. 12)
  - Complications (Fig. 13)
  - Procedure
- EMBRYO TRANSFER (FIG. 14)
- LUTEAL PHASE SUPPORT
- LABORATORY ASPECTS (FIGS 15 TO 19)
  - Equipment
  - Media and Environment
- OOCYTE DONATION
- SURROGACY
- CRYOPRESERVATION
- IVM
  - Technique
- PGD (Fig. 20)
- LASER ASSISTED HATCHING
- COMPLICATIONS OF ART
  - Multiple Gestation
  - Pregnancy Complications
  - Congenital Anomalies
  - Ovarian Stimulation and Cancer
- OHSS
- JUSTIFICATION OF ART
51:Male Infertility Surgery
- INTRODUCTION
  - Surgical Treatment of Infertility
- SURGERY FOR VARICOCELE
- LAPAROSCOPIC LIGATION
- SURGERY FOR MALE REPRODUCTIVE TRACT OBSTRUCTION
  - Preferred Anesthesia
  - Common Operations for Male Reproductive Tract Obstruction
- TESTICULAR BIOPSY
- SPERM RETRIEVAL TECHNIQUES
- SURGERY FOR ERECTILE and EJACULATORY DYSFUNCTION
  - Ejaculatory Dysfunction
  - Erectile Dysfunction
- CONCLUSION
52:Male Sterilization, Vasectomy
- INTRODUCTION
  - Indications
- ELIGIBILITY CRITERIA (WHO-IPPF)4
- COUNSELING AND PREOPERATIVE INFORMATION
  - Vasectomy Procedure Involves
    - The following information must be given to the patient:
- SELECTION OF CASES
- TECHNIQUE OF VASECTOMY
- RECENT ADVANCES
  - Fascial Interposition (FI)
- REVIEW OF LITERATURE
- CONCLUSION
53:Making of a Surgeon (A Practical Life and Guidance for Neo-surgeons)
- PROFESSIONAL DEVELOPMENT
54:Gynecological Surgery Instruments
- INTRODUCTION
Appendix ‘A’
Appendix ‘B’
Appendix ‘C’
- DIAGNOSTIC LAPAROSCOPY+ HYSTEROSCOPY
  - Preoperative Orders:
  - Operative Notes:
  - Steps:
- (SPACE FOR DIAGRAM AND FINDINGS AND COMMENTS)
- POSTOPERATIVE INSTRUCTIONS FOR DIAGNOSTIC LAPAROSCOPY AND HYSTEROSCOPY
- ABDOMINAL HYSTERECTOMY
  - Preop Orders:
  - Operative Notes:
  - Steps:
- VAGINAL HYSTERECTOMY
  - Preoperative Orders:
  - Operative Notes:
  - Steps:
- POSTOPERATIVE INSTRUCTIONS OF MAJOR PROCEDURES
  - Postoperative Orders :
- PREOPERATIVE QUESTIONNAIRE
- PREOPERATIVE INVESTIGATIONS
  - Based on the Age of the Patient
  - Based on Pre Existing Medical Condition
  - Based on Preoperative Drug Therapy
- PREOPERATIVE INSTRUCTIONS FOR THE PATIENT
  - Minimum Intraoperative Monitoring
- LIST OF ESSENTIAL EMERGENCY DRUGS
- LIST OF ADDITIONAL DRUGS FOR OPERATION THEATeR
- LIST OF “ANESTHETIC DRUGS” GA/REGIONAL
- SPECIAL DRUGS FOR OBSTETRIC OPERATION THEATeR
- CHECKLIST OF PREOPERATIVE PREPARATION
  - Patient Preparation
  - Theater Preparation
- ANESTHESIA RECORD
  - Preoperative Assessment
  - Premedication:
  - Investigations:
- ANESTHESIA NOTES
  - Postoperative Progress:
- POSTOPERATIVE INSTRUCTIONS DURING RECOVERY
- CHART FOR DISPLAY
  - Cardiac Arrest Management Protocol
- ALGORITHMS
  - Bradycardia Algorithm
- HEALTHCARE PROVIDER ALGORITHM
- PULSELESS ARREST ALGORITHM
- TACHYCARDIA ALGORITHM
- INFUSION RATES FOR SELECTED CARDIOVASCULAR MEDICATIONS
  - Nitroglycerin (25 mg/250 ml]= SO mg/500 ml= 100/ig/mi)
  - Lidocaine (2 gm/500 ml=4 mg/ml)
  - Dopamine Hydrochloride (800 mg/500 ml = 1600 ug/ml
  - Dobutamine Hydrochloride (250 mg/250 ml = 1000 ug/ml)
- Infusion Rates for Selected Cardiovascular Medications
  - Norepinephrine (4 mg/250 ml = 16/zg/ml)
  - Isoproterenol (2 mg/250 ml = 8/ug/ml)
  - Oxytocin Infusion Sharing Relationship Between drops/min and milliunits
- GUIDELINE FOR MANAGEMENT OF AN ADULT PATIENT WITH SUSPECTED ANAPHYLAXIS DURING ANESTHESIA
  - Initial Therapy
  - Secondary Therapy

INDEX

TOC
Index

Chapter Notes