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Atlas of Pelvic Anatomy and Gynecologic Surgery E-Book

Atlas of Pelvic Anatomy and Gynecologic Surgery E-Book

Michael S. Baggish | Mickey M. Karram

(2015)

Additional Information

Book Details

Abstract

The updated edition of Atlas of Pelvic Anatomy and Gynecologic Surgery richly illustrates pelvic anatomy and surgical operations through full-color anatomic drawings, correlative surgical artwork with step-by-step photographs, and computer-assisted hybrid photo illustrations. Covering a compendium of gynecologic operations, including major and minor procedures and approaches, the techniques described feature a myriad of laparotomy, laparoscopic, robotic, hysteroscopic, vaginal, vulvar and cystoscopic operations. It is a truly comprehensive resource that's well suited for practicing obstetricians-gynecologists, obstetrics-gynecology residents, general surgeons, subspecialists, nurses, and medical students with an interest in gynecology.

  • Half-tone images and four-color clinical photographs aid in comprehending complex anatomic relationships.
  • Comprehensive coverage of conventional and endoscopic surgeries helps you master the full spectrum of surgical procedures.
  • Brand-new chapters include a third chapter on Pelvic Anatomy, A Comprehensive Atlas of Vulvar Disorders, Avoiding and Managing Mesh Complications, and Appropriate Use of Mesh for Pelvic Organ Prolapse.
  • Correlative drawings and full-color illustrations provide the clearest and best visual understanding on the market.
  • New Robotic Surgery chapter authored by Javier Magrina, renowned minimally invasive and robotic gynecologic surgeon.
  • Medicine eBook is accessible on a variety of devices.

Table of Contents

Section Title Page Action Price
Front Cover cover
Inside Front Cover ifc1
Atlas of Pelvic Anatomy and Gynecologic Surgery i
Copyright Page iv
Dedication v
Editors vi
Contributors vii
Preface ix
Acknowledgments xi
Table Of Contents xiii
Video Contents xvi
Fresh Cadaver Dissection xvi
Fixed Cadaver Dissection xvi
1 Principles of Pelvic Anatomy and Gynecologic Surgery 1
1 Pelvic Anatomy 3
1 Basic Pelvic Anatomy 5
2 Advanced Pelvic Anatomy 59
Autonomic Nervous System 59
Pelvic Plexus 64
Sigmoid Colon 64
Bladder and Pelvic Supports 64
3 Max Brödel’s Pelvic Anatomy 75
2 Basic Foundations for Gynecologic Surgery 93
4 Instrumentation 95
Forceps 95
Clamps 95
Scissors 95
Knives 95
Retractors 95
Needle Holders 102
Dilators 102
Curettes 102
Suction Curettes 102
5 Suture Material, Suturing Techniques, and Knot Tying 109
Suture Types 109
Suture Selection 109
Suture Techniques 114
Knot Tying 114
Surgeon’s Knot 114
Instrument Tie 114
Finishing a Continuous Stitch 114
6 Energy Devices 129
Electrosurgery—Laser—Harmonic Scalpel 129
Electrosurgery 129
Laser Surgery 132
Ultrasonic Surgery 136
7 Positioning and Nerve Injury 139
Positioning the Patient 139
Peripheral Nerve Injury 141
Compartment Syndrome 147
2 Abdominal Surgery 151
3 Anterior Abdominal Wall 153
8 Anatomy of the Lower Abdominal Wall 155
Vessels 161
9 Abdominal Incisions 165
Transverse Incisions 165
Maylard Incision 165
Pfannenstiel Incision 169
Cherney Incision 169
Kustner Incision 169
Midline Incision 175
4 Uterus 177
10 Intra-abdominal Pelvic Anatomy 179
Uterine Support 179
Pelvic Anatomy 182
11 Dilatation and Curettage 205
Suction Curettage 210
12 Abdominal Hysterectomy 213
Total Abdominal Hysterectomy With Bilateral Salpingo-oophorectomy 213
Subtotal Hysterectomy 233
Simple Abdominal Hysterectomy 235
Laparoscopic Hysterectomy 237
13 Radical Hysterectomy 247
Supplemental Anatomy for Radical Hysterectomy and Pelvic Lymphadenectomy 247
Radical Hysterectomy and Pelvic Lymphadenectomy 247
14 Endometrial Carcinoma With Lymph Node Sampling 263
15 Myomectomy 265
16 Surgical Treatment of Unusual Myoma Conditions 275
17 Unification of Bicornuate Uterus 279
5 Abdominal Surgery During Pregnancy 287
18 Abdominal Cerclage of the Cervix Uteri 289
19 Cesarean Section 293
20 Cesarean Section Hysterectomy 301
21 Hypogastric Artery Ligation 305
22 Trophoblastic Disease 307
6 Adnexa 317
23 Ovarian Cystectomy and Cystotomy 319
24 Surgery for Pyosalpinx, Tubo-ovarian Abscess, and Pelvic Abscess 325
25 Adhesiolysis 331
26 Surgical Management of Pelvic Endometriosis 339
27 Surgical Management of Ectopic Pregnancy 347
Linear Salpingostomy for Tubal Ectopic Pregnancy 347
Cornual Excision and Salpingectomy for Cornual Ectopic Pregnancy 347
Salpingectomy for Isthmic Ectopic Pregnancy 347
28 Surgical Management of Ovarian Residual and Remnant 359
29 Ovarian Tumor Debulking 361
30 Tuboplasty 365
Fimbrioplasty (Hydrosalpinx) 365
Midtubal Anastomosis 368
Cornual Anastomosis 369
31 Tubal Sterilization 371
Modified Irving Procedure 371
Pomeroy Operation 371
Fimbriectomy 371
Simple Bilateral Partial Salpingectomy 376
Uchida Operation 376
Silastic Band Operation 376
7 Retropubic Space 381
32 Anatomy of the Retropubic Space 383
33 Operative Setup and Entry Into the Retropubic Space 401
34 Retropubic Urethropexy for Stress Incontinence 405
Modified Burch Colposuspension 405
Marshall-Marchetti-Krantz Procedure 405
35 Retropubic Paravaginal Repair 409
36 Retropubic Vesicourethrolysis 413
8 Retroperitoneum and Presacral Space 417
37 Anatomy of the Retroperitoneum and the Presacral Space 419
38 Identifying and Avoiding Ureteral Injury 435
Exposing the Ureter 435
Anatomic Relationships of Right and Left Ureters 442
39 Presacral Neurectomy 449
40 Uterosacral Nerve Transection 455
41 Lymph Node Sampling 459
9 Abdominal Operations for Enterocele and Vault Prolapse 465
42 Native Tissue Suture Repair of Vaginal Vault Prolapse 467
Nonsupportive Obliterative Procedures of the Pelvic Cul-De-Sac 467
Moschcowitz Culdoplasty 467
Halban Culdoplasty 467
Supportive Procedures of the Vaginal Apex 467
Uterosacral Ligament Plication 468
Uterosacral Ligament Suspension 468
43 Abdominal Sacral Colpopexy and Colpohysteropexy 475
Technique for Open Abdominal Sacral Colpopexy with Graft Placement 475
Technique for Laparoscopic Sacral Colpopexy 482
Modifications for Cervicosacropexy 482
Technique for Abdominal Sacral Colpohysteropexy 486
3 Cervical, Vaginal, Vulvar Surgery 489
10 Cervical Surgery 491
44 Anatomy of the Cervix 493
45 Cervical Biopsy, Endocervical Curettage, and Cervical Biopsy During Pregnancy 499
Cervical Biopsy 499
Endocervical Curettage 499
Cervical Biopsy During Pregnancy 499
46 Conization of the Cervix 505
Cold-Knife Conization 505
Laser Conization 509
Conization During Pregnancy 511
Loop Electrical Excision Conization 511
Loop Electrical Excision by Selective Double-Excision (“Top Hat”) Technique 511
Combination Conization 511
47 Cervical Polypectomy 519
48 Relief of Cervical Stenosis 523
49 Cervical Cerclage 527
50 Cervical Stump Excision (Trachelectomy) 533
11 Vaginal Surgery 539
51 Anatomy of the Vagina 541
Lower Third 541
Middle Third 541
Upper Third 541
52 Anatomy of the Support of the Anterior and Posterior Vaginal Walls 559
53 Vaginal Hysterectomy 567
Simple Vaginal Hysterectomy 567
Surgical Technique 567
Vaginal Salpingo-oophorectomy 575
Evaluating the Posterior Cul-de-sac 575
Difficult Vaginal Hysterectomy 584
Complete Uterine Procidentia 584
Obliteration of the Vesicouterine Fold 591
Adhesions of the Posterior Cul-de-sac 591
Removal of the Large Uterus 591
54 Native Tissue Vaginal Repair of Cystocele, Rectocele, and Enterocele 599
Anterior Vaginal Wall Prolapse 599
Midline Cystocele Repair 607
Vaginal Paravaginal Repair 617
Posterior Vaginal Wall Defects 622
Vaginal Enterocele Repair 622
Rectocele Repair 634
55 Vaginal Native Tissue Suture Repair of Vaginal Vault Prolapse 647
Sacrospinous Ligament Suspension 647
Iliococcygeus Fascia Suspension 658
High Uterosacral Ligament Suspension 659
56 Obliterative Procedures for the Correction of Pelvic Organ Prolapse 679
Obliterative Procedures 679
LeFort Partial Colpocleisis 679
Colpectomy and Colpocleisis 679
57 Use of Biologic and Synthetic Mesh to Augment Vaginal Prolapse Repair 687
Synthetic Mesh Augmentation 695
58 Synthetic Midurethral Slings for the Correction of Stress Incontinence 699
Retropubic Synthetic Midurethral Slings 699
Surgical Technique: Bottom to Top 704
Surgical Technique: Top to Bottom 710
Transobturator Synthetic Midurethral Slings 713
Surgical Technique: Outside-In 720
Surgical Technique: Inside-Out 724
Single-Incision Midurethral Slings 728
Surgical Technique 730
Surgical Management of Postoperative Voiding Dysfunction 735
Technique for Synthetic Sling Loosening in the Acute Setting (7-14 Days) 735
Steps for Takedown of a Synthetic Midurethral Sling 735
59 Avoiding and Managing Synthetic Mesh Complications After Surgeries for Urinary Incontinence and Pelvic Organ Prolapse 739
U.S. Food and Drug Administration Warnings 739
Mesh-Related Complications After Sacrocolpopexy 740
Mesh Complications After Synthetic Midurethral Slings 742
Vaginal Erosion 742
Bladder Perforation 742
Urethral Erosion 742
Complications After Transvaginal Mesh Placement for Pelvic Organ Prolapse 744
Mesh Erosion/Extrusion 744
Dyspareunia and Pelvic/Vaginal Pain 744
Visceral Injury 745
60 Biologic Bladder Neck Pubovaginal Slings for the Correction of Stress Incontinence 749
Managing Postoperative Voiding Dysfunction 762
61 Benign Lesions of the Vaginal Wall 765
Biopsies 765
Cysts 765
Ulcers 765
Solid Masses 765
62 Congenital Vaginal Abnormalities 779
Labial Fusion/Agglutination 779
Imperforate Hymen 779
Vaginal Agenesis 783
Transverse Vaginal Septum 793
Longitudinal Vaginal Septum 796
Obstructed Hemivagina 796
Bladder Exstrophy 796
63 Iatrogenic Vaginal Constriction 799
Incisions 799
Z-Plasty 799
Free Skin Grafts 805
Xenografts 805
Perineal Flaps 805
Abdominal Flaps 806
64 Vaginectomy 815
Excision 815
Carbon Dioxide Laser 818
12 Vulvar and Perineal Surgery 821
65 Vulvar and Perineal Anatomy 823
66 Atlas of Vulvar Disorders 841
Embryonic 841
Infections 841
Parasitic Infections 841
Bacterial Infections 843
Fungal Infections 843
Viral Infections 843
Spirochetal Infections 843
Other Venereal Infections 843
Noninfective Inflammatory Lesions 852
Lichenification Disorders 853
Hyperplastic Vulvitis 857
Cystic Lesions 857
Bullous-Ulcerative Lesions, Including Tubercular Lesions 857
Intraepithelial and Invasive Neoplasia 862
Gross Findings 862
Microscopic Findings 862
Invasive Cancer of the Vulva 867
Blood Vascular Lesions 871
Sampling Techniques 872
67 Bartholin Duct Cyst and Abscess 875
68 Surgery for Vulvar Vestibulitis Syndrome (Vulvodynia) 879
Simple Vestibulectomy 879
Vestibulectomy With Radical Bartholin Gland Excision 879
69 Wide Excision With or Without Skin Graft 887
70 Laser Excision and Vaporization 895
Laser Excision by Thin Section 895
Laser Vaporization 895
71 Anatomy of the Groin and Femoral Triangle 903
72 Vulvectomy 909
Simple Vulvectomy 909
Radical Vulvectomy 916
73 Radical Vulvectomy With Tunnel Groin Dissection 929
74 Vulvar Hematoma 937
75 Correction of Clitoral Phimosis 939
76 Hymenotomy (Hymenectomy) 943
77 Plastic Repair of the Perineum (Perineorrhaphy) 945
78 Benign Lesions of the Groin and the Canal of Nuck 951
Hidradenitis and Other Groin Lesions 951
Lesions of the Canal of Nuck 951
79 Surgery for Other Benign Lesions of the Vulva 959
Inclusion Cyst 959
Hidradenoma 959
Labial Fusion 959
Draining Vulvar Lesions 962
Vulvar Hemangiomas and Varicosities 962
Lymphangioma 967
Condyloma Acuminata 967
80 Therapeutic Injection 973
Alcohol Injection 973
Dexamethasone Injection 973
81 Episiotomy 977
Mediolateral Episiotomy 977
Midline Episiotomy 982
Repair of Third-Degree Laceration 982
Repair of Fourth-Degree Laceration 982
4 Other Related Gynecologic Surgery 989
13 Surgical Procedures Performed on the Lower Urinary Tract 991
82 Anatomy of the Urethra 993
83 Surgical Repair of Urethral Prolapse 1001
84 Repair of Urethrovaginal Fistula 1003
85 Repair of Suburethral Diverticulum 1009
86 Martius Fat Pad Transposition and Urethral Reconstruction 1019
Martius Fat Pad Transposition 1019
Urethral Reconstruction 1019
87 Surgical Anatomy of the Bladder and Pelvic Ureter 1027
88 Suprapubic Catheter Placement 1033
89 Repair of Advertent and Inadvertent Cystotomy 1039
Opening and Closing the Bladder 1039
Repair of Bladder Lacerations 1039
90 Abdominal Repair of Vesicovaginal and Vesicouterine Fistula 1047
Abdominal Repair of Vesicovaginal Fistula 1047
Repair of Vesicouterine Fistula 1055
91 Vaginal Repair of Vesicovaginal Fistula 1059
92 Managing Ureteral Injury During Pelvic Surgery 1067
Ureterotomy and Catheterization 1069
Ureteroureterostomy 1071
Ureteroneocystostomy 1073
Ureteroneocystostomy With Bladder Extension 1076
Boari-Ocherblad Flap 1076
93 Surgical Management of Detrusor Compliance Abnormalities 1081
Evaluation of Patients 1081
General Introduction to Three Modalities 1081
Surgical Techniques 1084
Sacral Neuromodulation 1084
Botulinum Toxin Bladder Injections 1091
Augmentation Cystoplasty 1091
14 Bowel Surgery 1099
94 Intestinal Surgery 1101
Anatomy of the Small and Large Intestine 1101
95 Small Bowel Repair/Resection 1109
96 Closure of a Simple Transmural Injury to the Small Intestine 1113
97 Meckel’s Diverticulum 1117
98 Appendectomy 1119
99 Colon Repair/Colostomy Creation 1123
Large Bowel Preparation 1126
100 Repair of Rectovaginal Fistulas 1127
Transvaginal Repair of Rectovaginal Fistula 1127
Transanal Endorectal Advancement Flap Procedure 1127
101 Anal Sphincter Repair With Perineal Reconstruction 1133
Anatomy of the Rectum and Anal Sphincters 1133
Repair of the Anal Sphincter 1134
102 Transperineal Repair of Rectal Prolapse 1143
Perineal Proctectomy (Altemeier Repair) 1143
15 Cosmetic and Gender Reassignment Surgery 1149
103 Surgery for Labial Hypertrophy 1151
104 Vaginoplasty and Perineal Reconstruction 1159
16 The Breast 1167
105 The Breast 1169
Anatomy of the Female Breast 1169
Clinical Breast Examination 1174
Fine-Needle Aspiration 1177
5 Endoscopy and Endoscopic Surgery 1181
17 Hysteroscopy 1183
106 Hysteroscopic Instrumentation 1185
107 Indications and Techniques 1193
108 Removal of Uterine Septum 1197
109 Ablation Techniques 1201
110 Minimally Invasive Nonhysteroscopic Endometrial Ablation 1211
Complications 1211
111 Resection of Submucous Myoma 1217
112 Complications of Hysteroscopy 1223
18 Laparoscopy 1227
113 Pelvic Anatomy From the Laparoscopic View 1229
114 Trocar Placement 1235
Anatomic Sites for Access 1235
Umbilicus 1235
Left Upper Quadrant (Palmer’s Point) 1235
Other Sites 1235
Choosing the Suitable Anatomic Site for Access 1235
General Principal for Primary Access to the Peritoneal Cavity 1237
Techniques for Access 1237
Direct Trocar Technique 1237
Optical Trocar Technique 1237
Use of Veress Needle Technique 1237
Open (Hasson) Technique 1237
Choosing a Technique for Abdominal Cavity Access 1240
Complications (see Chapter 121) 1240
Vascular Injury 1240
Visceral Injury 1240
Accessory Trocar Insertion 1240
Conclusion 1241
115 Diagnostic Laparoscopy 1243
Standard Diagnostic Laparoscopy 1243
Microlaparoscopy 1243
116 Laparoscopic Hysterectomy 1247
Single-Port Laparoscopic Hysterectomy 1250
117 Laparoscopic Adnexal Surgery 1255
Ovarian Cystectomy 1255
Salpingo-Oophorectomy 1257
Ectopic Pregnancy 1257
Tubal Ligation 1261
Tuboplasty 1261
118 Laparoscopic Surgery for Stress Urinary Incontinence (Burch Colposuspension) 1263
119 Laparoscopic Surgery for Pelvic Organ Prolapse 1267
Laparoscopic Sacral Colpopexy 1267
Laparoscopic Uterosacral Ligament Plication and Shortening 1267
120 Robotic Surgery in Gynecology 1271
Comparison of Laparoscopy and Robotics Technology 1271
Da Vinci Surgical System 1271
Applications in Gynecology 1271
Robotic Simple Hysterectomy 1271
Robotic Column Location 1272
Trocar Position 1272
Robotic Instrumentation 1274
Assistant and Scrub Nurse Roles 1275
Technique 1276
Infundibulopelvic Ligament Sealing and Division 1276
Division of Pelvic Peritoneum and Round Ligament 1277
Division of Uterine Vessels 1277
Bladder Mobilization: Dissection of the Vesicovaginal Space 1277
Division of Cardinal Ligaments 1277
Colpotomy 1277
Removal of Uterus 1277
Cuff Closure 1277
Conclusions 1282
References 1282
121 Major Complications Associated With Laparoscopic Surgery 1283
Vascular and Intestinal Injury 1283
Laparoscopic Approach 1283
Operative Procedure 1304
Ureteral Injury 1304
19 Cystourethroscopy 1317
122 Cystourethroscopy 1319
Instrumentation 1319
Indications and Techniques 1321
Urethroscopy (Normal and Abnormal Findings) 1321
Cystoscopy (Normal and Abnormal Findings) 1329
Operative Cystoscopy 1340
Bladder Biopsy 1340
Ureteral Catheterization 1340
Injection of Bulk-Enhancing Agents 1340
Suprapubic Telescopy 1346
6 Surgery for Transgender Conditions 1349
20 Surgery for Transgender Conditions 1351
123 Surgery for Transgender Conditions 1353
Index 1367
A 1367
B 1368
C 1369
D 1370
E 1370
F 1371
G 1371
H 1371
I 1372
J 1373
K 1373
L 1373
M 1374
N 1375
O 1376
P 1376
Q 1377
R 1377
S 1378
T 1379
U 1380
V 1381
W 1382
X 1382
Y 1382
Z 1382
Inside Back Cover ibc1