Beruflich Dokumente
Kultur Dokumente
•Menorrhagia
•Pelvic pressure
•Pelvic pain
•Leiomyosarcoma
•Myomas
•Degenerating myoma
•Fibroids
•Prolapsed myoma
•Pedunculated myoma
•Bladder pressure
•Urinary frequency
RISK ASSESSEMENT
•Endometrial cancer
•Uterine sarcoma
•Pregnancy
•Asymptomatic patients
•Heart diseases
•Diabetes
•Hypertension
•Bleeding disorders
•PID
PREPARATION OF THE PATIENT
•Blood tests
•Urinalysis
•Chest X-ray
•ECG
•Pregnancy test
•USG
•CT scan
•MRI
•Endometrial biopsy
•Hysterosalpingography (HSG)
•Hysteroscopy
•Stop using blood thinning medication
ANESTHESIA
•General anesthesia
•Local anesthesia
•Spinal anesthesia
THE PROCEDURE
ABDOMINAL MYOMECTOMY
•A Pfannenstiel incision was given
•Abdomen was opened in layers
•Vasopressin and saline was injected into the serosa prior to the
uterine incision
•An incision was made through the wall of the uterus into the
myoma.
•The plane between the myometrium and myoma was defined
•Myoma was dissected bluntly and sharply and the entire fibroid was
removed
•The defect was closed in layers with delayed absorbable suture.
coccyx and sacrum well supported on the flat surface of the table.
•The patient's legs were secured in the leg stirrups to avoid any
patient’s abdomen
•The cervix was manually dilated with metal dilators to the same
•After the cervix was dilated, the hysteroscope was inserted into the
endocervical canal and advanced into the uterine cavity with the
distention medium flowing under direct visualization to limit the risk
of perforation.
•The tenaculum on the cervix was left in place to help in
the hysteroscope.
•A purse-string suture was placed around the cervix using 0-Vicryl to
AFTER PROCEDURE
•Patient was shifted to intensive care unit
•Patient was observed for temp, pulse rate, blood pressure,
oxygenation
FINDINGS
_____ Cms of _____Myoma was removed
DURATION
______min/hrs
POSTOPERATIVE CARE
•Take pain medication as prescribed
COMPLICATIONS
•Infection
•Hemorrhage
•Thromboembolism
•Uterine perforation
•Cervical trauma
•Cervical lacerations
•Peritonitis
•Sepsis
•Gas embolism
•Circulatory collapse
•Fluid overload
•Hyponatremia
•Hypervolemia
•Hypotension
•Pulmonary edema
•Cerebral edema