Uterus: A Colour Atlas of Caesarean Section (Volume 14) Narendra Malhotra, Arun Nagrath, Shikha Seth
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1Single Surgical Procedures in Obstetrics and Gynaecology–14 UTERUS: A Colour Atlas of Caesarean Section
2Single Surgical Procedures in Obstetrics and Gynaecology–14 UTERUS: A Colour Atlas of Caesarean Section
Series Editors Arun Nagrath MS MAMS FICOG Professor and Head Department of Obstetrics and Gynaecology Rural Institute of Medical Sciences and Research, Saifai, Etawah, Uttar Pradesh, India Erstwhile Professor and Head Department of Obstetrics and Gynaecology SN Medical College, Agra, Uttar Pradesh, India Senior Clinical Training Consultant Johns Hopkins Program for International Education in Gynaecology and Obstetrics (JHPIEGO), Baltimore, USA Narendra Malhotra MD FICOG FICMCH President, FOGSI 2008 Dean, ICMU 2008-2009 Director, Ian Donald School of Ultrasound Consultant and Director Malhotra Nursing and Maternity Home (P) Ltd., Agra, Uttar Pradesh, India Apollo Pankaj Hospital (P) Ltd., Agra, Uttar Pradesh, India Associate Editor Shikha Seth MD Associate Professor Department of Obstetrics and Gynaecology Rural Institute of Medical Sciences and Research, Saifai, Etawah, Uttar Pradesh, India
3
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This book has been published in good faith that the contents provided by the editors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Single Surgical Procedures in Obstetrics and Gynaecology–14: A Colour Atlas of Caesarean Section
First Edition: 2012
9789350256381
Printed at
4Dedication
One of the legendry artists’ surgeons of India who excelled and afforded respect to a newly formed specialisation Gynaecological and Obstetrical Surgeries.
… At the lotus feet of my master Late Professor Nawal Kishore MS FICOG FACS (Rockefeller Foundation Fellow)
Famous in the 50s, 60s and 70s fondly called Teacher of Teachers.
Through this great master, I see a glimpse of his surgical mannerisms in my work trying to achieve surgical perfection which came so naturally to him.
Lest he be forgotten in the footprints of time, a humble effort to propagate his excellence through this organisation for posterity.
lest the coming generations be starved of the magical art of gynaecological and obstetrical surgery.
Arun Nagrath
5Preface
Anything that simplifies our medical education is always welcomed. This series, “Single Surgical Procedures in Obstetrics and Gynaecology” is organised into multiple volumes based on all gynaecological and obstetrical surgical procedures related to female reproductive organs. Special sections are dedicated to patient positioning, type of incisions, their closures along with proper use of drains, suture choices, etc. Special emphasis is placed on different aspects of surgical options for various types of genital prolapse, and non-descent vaginal hysterectomy (NDVH) in different situations.
We, as editors of this “Colour Atlas of Caesarean Section”, have set out to simplify surgery by creating a step-by-step procedural process, illustrated to emphasise those surgical steps which are critical to caeserean delivery. The technique of lower segment as well the classical upper segment caesarean section has been covered. We have also provided important notes in an effort to aid the surgeons in reducing blood loss, minimising complication rates, and improving their surgical skills.
All the commonly done obstetrical and gynaecological procedures are illustrated in this series. Nevertheless, some rarely done procedures required by very selected group of cases are also discussed in different volumes so that one can assist the experienced surgeon with this, serving as a source of basic information illustrating the surgical technique.
We hope that the resident gynaecologic surgeon will find this series of books on surgical procedures very useful as he or she prepares for a career in this area of surgery and begins to perform these procedures. We believe that the experienced gynaecologic surgeon will also find this as a useful reference with many new approaches and helpful notes for commonly performed operations.
Arun Nagrath
Narendra Malhotra
Shikha Seth
6Acknowledgements
I am grateful to Director, Brig T Prabhakar, who has a fixation for quality and continued progress, dedicated to his institution. He has always cajoled his staff to move forward and do something that ‘makes a difference’. This series is an attempt in this direction. All through our hours of toil, he always helped us in smoothening the rough edges and this work carries the hallmark of his ‘quality’.
I am thankful to all the staff of the Department of Obstetrics and Gynaecology of UP Rural Institute of Medical Sciences and Research, Saifai, Etawah, Uttar Pradesh, India for their contribution in this project.
My better half, Dr (Mrs) Manju Nagrath, Department of Radiodiagnosis, UP Rural Institute of Medical Sciences and Research, Saifai, Etawah, Uttar Pradesh, India, who has stood by me, tolerating my hours of frustration and its manifestations and constantly encouraging me to ‘keep up’ my endeavours and see this work through completion.
The preparation of the book of this magnitude involves many individuals who play a role in its creation. I am especially proud of the quality of the photographs and it would be in place to put on record the contribution of Mr Dharmendra, Photographer of excellence, Department of Social and Preventive Medicine, UP Rural Institute of Medical Sciences and Research, Saifai, Etawah, Uttar Pradesh, India, for his untiring assistance.
To our patients who have very kindly consented to allow the use of their operative sequences for the purpose of advancement of medical education.
Arun Nagrath
7All Volumes in the Series “Single Surgical Procedures in Obstetrics and Gynaecology”
This book is one of the titles in the series of Single Surgical Procedures in Obstetrics and Gynaecology, a series which will eventually have 36 volumes.
If you wish to be kept informed of new additions to the series and receive details of our other titles, please write to Jaypee Brothers Medical Publishers (P) Ltd at sujatha.jp@gmail.com.
We list below a few of the other titles in print and in preparation in the Single Surgical Procedures series. Titles already published are marked (*); those titles to be published during the coming months are marked (#).
 
VULVA – A
VOL-1
Bartholin's gland excision
Marsupilisation of bartholin cyst
Release of labial fusion
VOL-2
Hymenectomy (Imperforate hymen)
Simple vulvectomy
 
VAGINA – B
VOL-3
Anterior colporrhaphy and Kelly's plication
Posterior colpoperineorrhaphy
Vaginal repair of enterocoel
Abdominal repair of enterocoel
VOL-4
Complete perineal tear repair
VOL-5
Fenton's operation
Episiotomy
Schuchardt's operation
 
CERVIX – C
VOL-6
Biopsy of cervix
Cervical conisation
Endocervical curettage at colposcopy
Conisation of cervix by LEEP
Electrocauterisation of cervix
Cervical cryocauterisation
VOL-7
Trachelorrhaphy
Abdominal excision of cervical stump
VOL-8
Correction of incompetent cervix by Shirodkar's technique
Correction of incompetent cervix by McDonald's operation
Correction of incompetent cervix by Lash operation
 
UTERUS: ABDOMINAL HYSTERECTOMY-D1
VOL-9
Total abdominal hysterectomy
Total abdominal hysterectomy with bilateral salpingo-oophorectomy
Nagrath's minilap hysterectomy
VOL-10
Abdominal subtotal hysterectomy
Obstetrical hysterectomy
 
UTERUS: VAGINAL HYSTERECTOMY-D2
VOL-11
NDVH – Conventional approach
NDVH – With salpingo-oophorectomy
NDVH – Debulking by uterine bisection
NDVH – Debulking by wedge excision
NDVH – Debulking by myomectomy
NDVH – Debulking by morcellation
NDVH – Debulking by Coring
NDVH – Debulking by spiral incision
NDHV – Debulking by cervical amputation
NDHV – Debulking by cervical wedge
*VOL-12
Ward Mayo's hysterectomy
Modified Ward Mayo's hysterectomy—Dr Nagrath's modification
Clampless vaginal hysterectomy
 
UTERUS-D3
VOL-13
Dilatation and curettage
Suction curettage for abortion
Dilatation and endometrial biopsy
Fractional curettage
*VOL-14
Upper segment caesarean section
Lower segment caesarean section
 
UTERUS: DISPLACEMENTS-D4
#VOL-15
Cervicopexy (Purandare's)
#VOL-16
Supravaginal cervical amputation (Nadkarni's)
VOL-17
Manchester's operation
Fothergill's repair
VOL-18
Shirodkar's anterior sling
Shirodkar's posterior sling
VOL-19
LeFort's operation
Gilliam's operation
Modified Gilliam's operation
William Richardson's operation
#VOL-20
Ventral suspension of vaginal vault
Abdominal sacro-colpopexy
8
 
UTERUS: MYOMECTOMY-D5
VOL- 21
Myomectomy for Fundal fibroid, Hood's operation
Myomectomy for anterior wall fibroid
Myomectomy for isthmic fibroid
Myomectomy for anterior cervical fibroid
Myomectomy for posterior wall fibroid
Myomectomy for intracavitary fibroid
Myomectomy for fibroid polyp
Myomectomy for broad ligament fibroid
Myomectomy for round ligament fibroid
Myomectomy for multiple fibroids
 
FALLOPIAN TUBES AND OVARIES-E1
VOL-22
Salpingo-oophorectomy
Wedge resection of ovary
Ovarian cystectomy
Ovariotomy
VOL-23
Enucleation of broad ligament cyst
Ectopic pregnancy
 
FALLOPIAN TUBE RECONSTRUCTION-E2
VOL-24
Salpingolysis
Fimbriolysis
Salpingo-ovariolysis
Salpingostomy
Salpingectomy
VOL-25
Cornual reimplantation
Fimbrioplasty
Tuboplasty—Microresection and anastomosis
 
FEMALE STERILISATION-E3
VOL-26
Laparoscopic sterilisation by silastic bands
Sterilisation by minilaparotomy technique
Sterilisation by pomeroy's operation
Sterilisation by modified pomeroy's operation
Sterilisation by Irving's method
Sterilisation by Uchida's method
Sterilisation by Madlener's method
Sterilisation by Parkland's method
Sterilisation by Aldridge method
Sterilisation by Kroener's method
Sterilisation by Oxford's method
Sterilisation by Shirodkar's method
Fimbriectomy
 
ABDOMINAL WALL-F
*VOL-27
Infra-umbilical midline laparotomy
Paramedian abdominal incision
Pfannenstiel's incision
Kustner's incision
Maylard's incision
Cherney's incision
VOL-28
Abdominal closure
Single layer abdominal closure
Skin closure methods
Use of drains
Incisional hernia repair
 
URINARY STRESS INCONTINENCE-G
VOL-29
Retropubic urethropexy
Kelly's operation
Marshall Marchetti Krantz operation
Burch suspension operation
 
CONGENITAL ANOMALIES-HI
VOL-30
Strassmenn's utriculoplasty
Jone's utriculoplasty
Tompkin's utriculoplasty
VOL-31
Excision of transverse vaginal septum
Excision of longitudinal vaginal septum
VOL-32
Mc Indoe's vaginoplasty
Modified McIndoe's vaginoplasty
William's vulvo-vaginoplasty
VOL-33
Ileal neovagina
 
FISTULA OPERATIONS
VOL-34
Layer method of RVF
Sim's Moir saucerisation
Latzko's operation
VOL-35
Urethral reconstruction
Vesicovaginal fistula
Vesicocervical fistula
Ureterivaginal fistula
 
MISCELLANEOUS OPERATIONS-J
VOL-36
Intestinal loop urinary diversion
Urinary diversion cutaneous ureterostomy
Urinary diversion uretero-sigmodostomy
Ureterovesicle anastomosis (psoas hitch)
Posterior colpotomy
Insertion of suprapubic catheter
Demonstration of tubal patency via laparoscopy
Demonstration of tubal patency by HSG