By Victor Gomel, Andrew Brill
New considering and advances in surgical procedure have revolutionized the analysis and therapy of universal gynecologic stipulations. Endometriosis, uterine fibroids, utero-vaginal prolapse, urinary incontinence, ovarian neoplasms, and adhesions are yet a number of the components the place even a normal gynecologist has to be conscious of the hot possibilities provided and considered necessary potential. also, in parallel with the present pattern to hold up being pregnant, there's an expanding consciousness inside gynecologic surgical procedure that fertility maintenance will be a crucial objective each time attainable. As a part of this variation of emphasis, reproductive surgical procedure is changing into reconnected with mainstream gynecologic surgical procedure. This ground-breaking publication from a hugely uncommon editorial group educates surgeons at the suggestions and systems now wanted in either reconstructive and reproductive surgical procedure in Gynecology; it truly is illustrated through schematic artwork and colour pictures of operative methods.
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Extra info for Reconstructive and Reproductive Surgery in Gynecology
Example text
This allows physicians to use lower power settings and to cause less thermal spread. Consequently, electrosurgical performance is markedly enhanced and the tissue product is more uniform and predictable (13). Fulguration Fulguration (aka superficial coagulation or spray coagulation) uses high-voltage sparking produced by the coag output to coagulate a broad surface with open vessels on end where coaption is not feasible or desirable. As opposed to the continuous arcing produced by the cut output, the highly interrupted coag output causes the arcs to strike the tissue surface in a widely dispersed and random fashion.
Since the position of the umbilicus in relation to the bifurcation is quite variable, it should not be used to define its location. The position of the umbilicus relative to the aortic bifurcation has been shown to be negatively correlated with body mass index (BMI) (6) (Fig. 2). However, the risk of vascular injury below the bifurcation still remains; one group reported that the space between the common iliac arteries was always at least partially occupied by the left common iliac vein and was completely filled by this vessel in 19 (28%) of 97 cases studied (7).
CONCLUSIONS Science becomes art and art becomes function when fundamental principles are utilized to dictate surgical practice. Most importantly, the risk for inadvertent thermal injury during electrosurgery can be minimized by a sound comprehension of the predictable behaviors of electricity in living tissue. Guided by the Hippocratic charge to “primum non nocere,” the ultimate aim of energy-assisted surgery is the attainment of anatomical dissection and hemostasis with the 27 least amount of collateral damage and subsequent scar tissue formation.