Abdominal Hysterectomy

Dr. Lauren Hamiliton discusses suitable candidates for abdominal hysterectomies.

Live webcast: Robotic-Assisted Hysterectomy

More than half a million times annually in the US, cancer and other serious conditions warrant hysterectomy-- the removal of a woman's uterus.
Usually the procedure is performed via an abdominal incision that requires a 3- to 5-day hospital stay and a 6- to 8-week recovery period. Now, in a handful of hospitals around the country, new robotic technology allows physicians to perform this procedure through small incisions that require a recovery time of only one night in the hospital and a significantly shorter recovery period at home.

Watch as Hartford Hospital surgeon Dr. Amy Brown performs this revolutionary new procedure live on www.OR-Live.com

Types of Hysterectomy (Hysterectomy Quick Tips #3)

www.HappyHysterectomy.com looks at the four main types of hysterectomy: abdominal, vaginal, LAVH and LSH.

Histerectomía Abdominal Total: Anestesia- anesthesia in hysterectomy

Enviado por " CONSULTORIO MÉDICO JAVIER FLORES BUISSON " MÁNCORA- PERÚ...
URL: http://consultoriomedicofloresmancora.es.tl/ ...
Se trata de una histerectomía abdominal total realizada el día de ayer 8 de Septiembre del 2009, debido a miomatosis uterina y endometriosis.
Varios métodos anestésicos se aplican con resultados satisfactorios para esta cirugía. Actualmente la anestesia neuroaxial es la más frecuentemente empleada porque ofrece numerosas ventajas, entre las que se destacan: menor respuesta al estrés quirúrgico, menor trobogénesis y embolia pulmonar subsecuente, mejor motilidad intestinal, menor incidencia de náuseas y sedación posoperatoria, mejor control del dolor, evita la manipulación de las vías respiratorias y la disfunción pulmonar, sin requerir además, tiempo para la emergencia anestésica y se asocia a disminución de las pérdidas sanguíneas.
Estas técnicas regionales son bloqueos perfectamente aceptados, cada una tiene algunas desventajas cuando se les utilizan como técnica única; pero al combinarlas se puede reducir o aun eliminar los riesgos de estas desventajas.
Se realizó medicación preanestésica inmediata con midazolán a dosis de 0,03 mg/kg de peso por vía EV, se administró solución salina 0,9 % a razón de 10 mL/kg de peso. Se estableció monitorización mínima indispensable previa al proceder. En posición sentada se realizó punción epidural con aguja de Touhy G17 en el espacio intervertebral a nivel de T11-T12 con colocación de catéter; posteriormente punción subaracnoidea entre los espacios intervertebrales L3-L4 con trocar SPINOCAM G25 y se inyectó fentanyl 25 µg más bupivacaína (0,5 %) 10 mg, y se mantuvo a la paciente por un periodo de 10 min en posición de Scultetus a 5 º. En decúbito dorsal se administró por vía epidural bupivacaína (0,5 %) 50 mg y dosis subsecuentes según necesidades. Se registraron las variables presión arterial media (PAM) y frecuencia cardiaca después de la medicación preanestésica y cada 5 min durante el transoperatorio.
En este caso, se requirió de diacepam y midazolam endovenoso para complementar el bloqueo motor, de ahi es que se observa a la paciente en estado inconciente y con ayuda respiratoria manual.
Uno de los inconvenientes de la anestesia epidural aislada es su alta frecuencia de analgesia insuficiente, entre otros motivos por su bloqueo menos denso, con la anestesia subaracnoidea epidural combinada esta desventaja se supera. Por otra parte, el empleo de opioides como coadyuvantes, intensifica y prolonga el bloqueo sensitivo sin modificar el bloqueo motor;8 su uso se multiplica en forma logarítmica y es un procedimiento rutinario que influye en la optimización de la anestesia regional.7 se coincide con publicaciones que describen mejor calidad del bloqueo sensitivo al aplicar anestesia subaracnoidea epidural combinada a doble espacio.
La anestesia subaracnoidea epidural combinada a doble espacios resultó una técnica satisfactoria para la histerectomía abdominal, con excelente bloqueo sensitivo, alto grado de bloqueo motor y baja incidencia de complicaciones.

A peridural catheter was placed at the thoracic level 11-12 and subarachnoid puncture was performed between the lumbar spaces 3-4. Fentanyl 25 µg and intrathecal bupivacaine (0.5 %) 10 mg and 50 mg of epidural bupivacaine (0.5 %) were injected. The mean of the arterial pressure descended 8 mmHg and the heart rate 4 beats/min with statistical significance.

Hysterectomy Removal of the Uterus PreOp® Patient Education Feature

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Your doctor has recommended that you have a hysterectomy. But what does that actually mean?

Hysterectomy is the removal of the uterus - the organ that holds and protects the fetus during pregnancy.

Hysterectomy often also involves the removal of other parts of the reproductive system, including the ovaries - where eggs are produced - the fallopian tubes which carry the eggs to the uterus and the cervix - or neck of the uterus.

There are many different reasons why a doctor may recommend this kind of surgery.

In many cases, disease or the growth of abnormal tissue will lead a doctor to recommend the removal of the uterus.

In some cases, unusually heavy menstrual flow and the accompanying discomfort may make hysterectomy an important treatment option for patient and physician to consider.

But no matter what the reason behind it, you should be aware that the removal of the uterus and other reproductive organs is a serious step and it can mean significant changes in your life.

After having a hysterectomy, you will not be able to have children and if your ovaries are removed as part of the procedure, you may even need to take medication to replace hormones that your body once produced on its own.

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Your doctor will decide whether to make a vertical...
or horizontal incision.
An incision is made cutting through the skin and muscle of the abdomen.
Next, the surgeon will inspect the general condition of the abdominal organs.
Once the ovaries are exposed the uterus can then be separated from the bladder.
Next, the fallopian tubes are tied off and cut.
All arteries and veins connected to the uterus are tied off and cut as well.
Now the uterus can be pulled upward. This stretches the vagina
allowing the surgeon to cut the uterus free at the cervix.
The surgeon closes the top of the vagina with stitches,
and provides added support by attaching the ligaments that once held the uterus in place.
The incision is then closed...
and a drainage tube may be left inserted at the site.
Finally, a sterile bandage is applied.

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As a normal effect of hysterectomy, you will no longer menstruate and will not be able to have children. If your ovaries were removed you may be prescribed hormone replacement drugs.

Fortunately, Hysterectomy surgery only rarely leads to complications. One potential complication is a persistent residual neuralgia - or pain - around the scar.

It can be either localized or general. It may develop soon after surgery - or even weeks or months later. Usually it will decrease in intensity with time. But in very rare situations, it can become permanent.

A more serious complication comes from accidental damage to the bladder or urinary tract during surgery.
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Once you return home, you will be responsible to keeping the dressing intact and clean.

As with all surgery, you should be alert for signs of infection near the incision - increased swelling, redness, bleeding or other discharge. Your doctor may advise you to be on the alert for other symptoms as well. If you experience any unusual symptoms, report them to your doctor right away.


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Laproscopic Hysterectomy

Laproscopic Hysterectomy is the removal of the uterus through very small incisions so there is a quick recovery and very small, hardly noticable scars on the abdomen. There are also less complications

Hysterectomy for Benign Disease #1

http://www.us.elsevierhealth.com/product.jsp?sid=&isbn=9781416062714&lid=&iid=
Hysterectomy for Benign Disease, by Mark D. Walters, MD and Matthew D. Barber, MD, MHS, is the ideal way to enhance your skills in this key area of gynecologic surgery. In this volume in the Female Pelvic Surgery Video Atlas Series, edited by Mickey Karram, MD, hours of video footage, together with detailed discussions and illustrations, clarify how to most effectively perform a variety of hysterectomy operations and manage complications. Case-based videos take you step by step through simple and complicated abdominal hysterectomy; simple and complicated vaginal hysterectomy; laparoscopic and robotic hysterectomy; vaginal oophorectomy; endometrial procedures that avoid hysterectomy; and more.