1Single Surgical Procedures in Obstetrics and Gynaecology–15: UTERUS - DISPLACEMENTS A Colour Atlas of Cervicopexy (Purandare's)2
3Single Surgical Procedures in Obstetrics and Gynaecology–15: UTERUS - DISPLACEMENTS A Colour Atlas of Cervicopexy (Purandare's)
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
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Single Surgical Procedures in Obstetrics and Gynaecology–15: A Colour Atlas of Cervicopexy (Purandare's)
First Edition: 2012
9789350257623
Printed at
5Dedication
One of the legendry artists’ surgeons of India who excelled and afforded respect to a newly formed specialisation Gynaecological and Obstetrical Surgeries.
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
7Preface
Any thing that simplifies our medical education is always welcomed. This series, “Single Surgical Procedures in Obstetrics and Gynaecology” is organised into multiple volumes on all gynaecological and obstetrical surgical procedures related to female reproductive organs. Special sections are dedicated to patient positioning, type of incision, their closures along with proper use of drains, suture choices, etc. Special emphasis is placed on different aspects of surgical options for nulliparous prolapse, with special emphasis on cervicopexy, prticularly Purandare's cervicopexy or anterior sling/suspension operation.
We as editors of this Colour Atlas of Cervicopexy (Purandare's) have set out to simplify surgery by creating a step-by-step procedural process, illustrated to emphasise those surgical steps which are critical to the individual procedure under consideration. We have also provided important notes in an effort to aid the surgeon in reducing blood loss, minimising complication rates, and improving their surgical skills.
All the commonly done obstetrical and gynaecological procedures are illustrated in several volumes. 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 medicine and begins to perform these procedures. We believe that the experienced gynaecologic surgeon will also find this a useful reference with many new approaches and helpful notes for commonly performed operations.
Arun Nagrath
Narendra Malhotra
9Acknowledgements
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 smoothning 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.
11All 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 NDVH - Debulking by cervical amputation NDVH - 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 |
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 |