Managing complications at the time of vaginal hysterectomy
Proper technique for preserving ureteral integrity, repairing cystotomy, ensuring hemostasis, and reducing uterine size for transvaginal removal can help the surgeon avoid pitfalls during vaginal surgery
In this Article
- Ensuring ureter protection
- Cystotomy repair
- Bleeding control strategies
This article is based on the AAGL-produced and ACOG/SGS cosponsored Online Master Class on Vaginal Hysterectomy
When performing bilateral salpingo-oophorectomy, a long, fine clamp, such as the M.D. Anderson clamp, can help you reach up to control the gonadal vessels in the event that you lose your initial grip on those vessels (FIGURE 8).
Be prepared
Have a plan in place to manage any complications that arise during surgery. Just as obstetricians plan ahead to prepare for shoulder dystocia and other emergencies, gynecologic surgeons must prepare for surgical complications. Tissue extraction strategies can aid in the debulking and removal of large uteri, and the proper tools, lighting, and assistance are critical to success.
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