By Shirish S Sheth
Advances in laparoscopic know-how have ended in new curiosity within the vaginal method of hysterectomy, which has many confirmed advantages for sufferers. The authors the following warning that this expertise is helping in just a percent of circumstances. specialists clarify the indicators and contra-indications for the vaginal process, speak about preoperative overview strategies and provide an evidence-based elucidation of vaginal hysterectomy. With an entire profile of the aptitude issues, morbidity and mortality linked to the vaginal process, Vaginal Hysterectomy presents a well-balanced appraisal. it really is an important textual content for working towards gynecologists, surgeons, specialists and postgraduates.
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Sample text
Kadar [32] and Childers [33] have followed in North America. There can be little doubt that the vaginal approach to radical surgery for uterine cancer will be re-established [34]. Previous abdominal and pelvic surgery This is not a contraindication, especially with assessment via the laparoscope before the operation. Adhesions can be loosened and the vaginal operation proceeded with. Vaginal hysterectomy can safely be done in patients who have undergone several caesarean sections. Particular attention must be given to bladder dissection.
The place of oophorectomy at vaginal hysterectomy. Br J Obstet Gynaecol 1991; 98: 662–6. 26. Capen C, Irwin H, Margin J, Masterson B. Vaginal removal of ovaries in association with vaginal hysterectomy. J Reprod Med 1983; 28: 589–93. Page 14 27. Gross CP, Nicholson W, Powe NR. Factors affecting prophylactic oophorectomy in postmenopausal women. Obstet Gynecol 1999; 94: 962–8. 28. Schauta F. Die Hauptindication der Vaginalen Total – Exstirpation ist und bleibt des Carcinoma Uteri. Wien Med Bl 1890; 19: 551–3.
It is at this time that one sees the start of vaginal hysterectomy for indications other than genital prolapse. In 1940, Heaney [11] suggested that vaginal hysterectomy should not be advocated in the patient who had previous pelvic surgery. In many instances this is not the case. The popularity of vaginal hysterectomy fluctuated over the years and a few surgeons kept interest in the operation going when this was rapidly waning in favour of the abdominal approach. Krige [12] and the author were those in South Africa who favoured the operation over the abdominal approach.