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Surgical Skills on Internal Iliac Artery ligation for Controlling Postpartum & Pelvic Hemorrhage
Rekha Sapkal
CHAPTER 1:
Evidence-based Guidelines: Abstract of Research Paper
When Disaster Strikes in the Pelvis
Background
Objective
Results
Conclusion
CHAPTER 2:
Indications for Anterior Division of Internal Iliac Ligation, Operation Steps and Tips
Obstetric Indications with Hemorrhage for Internal Iliac Ligation
Gynecological Operations where Preventive Surgery can be done on Internal Iliac
Steps
Internal Iliac and Anterior Branch (Figs 2.1 to 2.23)
Right Side Finger Dissection (Figs 2.17 to 2.21)
CHAPTER 3:
Internal Iliac Artery: A Study on Cadaver
Introduction
Internal Iliac Anatomy and Working Knowledge of Vessel
Length of Vessel
Methodology—Right Side
CHAPTER 4:
Working Knowledge: Applied Anatomy
Introduction
Step 1—Exploration of Operation Field
Methodology
Identification of Ureters
Principles for Site of Incision
Check Points
Step 2—Direction and Extent of Incision on the Peritoneum
Methodology
Principles of Operation
Check Points
Step 3—Superficial Dissection with Fingers
Methodology
Principle
Check Points
Step 4—Dissection in Depth with Fingers
Methodology
Principle
Check Points
Step 5—Terminal Interior Division
Methodology
Principle
Check Points
Procedure on the Right Side
Methodology
Principle
CHAPTER 5:
Internal Iliac Artery Ligation of Anterior Division by Finger Dissection Methods
Internal Iliac Anatomy and Working Knowledge of Vessel
Finger Dissection Method for Internal Iliac Ligation
Anatomy
Upper Most Level of Incision
Lower Most Level of Incision (Fig. 5.4)
Step One
Decide the Place and Level of Incision
Step Two (Figs 5.6 to 5.8)
Recollect the Anatomy of the Common and External Iliac
Length of Incision
Step Three
Finger Dissection
Step Four
Extend Incision with Fingers (Fig. 5.12)
Recollect the Anatomy of the Internal Iliac Main Branch
Step Five: Explore the Vessels with Fingers in the Depth and on Medial Side (Fig. 5.17)
Step Six: Poke the Fingers Medially to External Iliac to Identify Internal Iliac
Direction of Anterior Division of Internal Iliac
Length of the Internal Iliac Vessel
Step Seven: Where to Ligate?
Step Eight: Look for Near by Veins Avoid their Handling (Fig. 5.33)
Step Nine: Artery Forceps is Pushed below Gently (Figs 5.34 to 5.38)
Step Ten: Create Few mm Space below the Artery with Finger Tip or Blunt Tip of Forceps (Fig. 5.39)
Step Eleven: Artery is Opened to Hold the Ligature which is Drawn Later (Figs 5.40 and 5.41)
Methodology—Right Side (Figs 5.42 to 5.53)
Complications
Operation
Finger Dissection Method of the Internal Iliac Ligation—Technical Points
CHAPTER 6:
Maternal Mortality Rate in India
Overview of Postpartum Hemorrhage in Rural Set-up
Conclusion
CHAPTER 7:
To Focus Postpartum Hemorrhage
Focus on Improving Operative Skills for Management of Postpartum Hemorrhage
Life Threatening Postpartum Hemorrhage as Obstetric Emergencies
Active Management of Labor
First Aid—Labor Ward Protocol Control of Bleeding
Course of Events Occurring with Postpartum Hemorrhage
Cesarean Section Complications
Choice of Next Operative Treatment for Control of Postpartum Hemorrhage
Uterus Saving Procedures
Couvelaire Uterus
CHAPTER 8:
Nutshell Take Home Message
Fifteen Years I took to Learn Internal Iliac Ligation
INDEX
TOC
Index
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