Gynae operations

Question 1

Diagnostic hysteroscopy

Answer 1

Inspection of uterine cavity through cervical canal distended using Co2/saline. No or local anaesthetic

Question 2

Hysteroscopic surgery

Answer 2

Diathermy/glycine irrigation fluid
TCRE- transcervical resection of endometrium
TCRF- transcervical resection of fibroids
with sterility-tubal/laser ablation/hot baloon/microwave probe

Question 3

Diagnostic lap

Answer 3

Peritoneal cavity insufflated with CO2 trocar laproscope. macroscopic pelvic disease, pelvic pain, dysmenorrhoea, infertility

Question 4

Lap sugery

Answer 4

sterilize, adhesions, endometriosis, ectopic pregnancy

Question 5

Total abdominal hysterectomy

Answer 5

Arteries and ligaments top to bottom then remove the uterus

Question 6

Vaginal hysterectomy

Answer 6

Reversal of removal from bottom to top. vaginal vault closed after hysterectomy is complete. used for uterine prolapse.

Question 7

Lap hysterectomy

Answer 7

LAVH-lap assisted vaginal H. steps 1+2 from lap, rest vaginally
TLH- all lap as an alt to TAH

Question 8

Wertheim’s radical hysterectomy

Answer 8

Removal of parametrium upper 1/3 vagina and pelvic lymph nodes for stage 1aii-2a cervical carcinoma

Question 9

Dilatation and curettage

Answer 9

Cervix dilated with hegar dilators or increasing size and endometrium is curetted to biopsy- not common

Question 10

ERPC

Answer 10

Cervix dilated and evacuation of RPOC using suction curette

Question 11

LLETZ

Answer 11

remove transformation zone of cervix where CIN is present

Question 12

Cone biopsy

Answer 12

Removes transformation zone and much endocervix. treats 1a and used for staging early cervical carcinoma. GA/epidural

Question 13

Repair operations

Answer 13

Anterior repair of a cystocoele or posterior repair of a rectocoele. levator ani on either side is plicated between rectum and vagina. Is person sexually active

Question 14

Hysteroplexy

Answer 14

resuspension of prolapsed uterus using a bifurcated mesh to lift the uterus and hold it in place

Question 15

Sarcocolpoplexy

Answer 15

for prolapsed vaginal wall after hysterectomy- mesh from vaginal vault to sacrum

Question 16

Sacrospinous fixation

Answer 16

Blind vaginal approach for vault prolapse

Question 17

TVT

Answer 17

Tension free vaginal tape used for urinary stress incontinence

Question 18

TOT

Answer 18

Transobturator tape

Question 19

Burch Colposuspension

Answer 19

Failed tape procedures- vaginal wall hitched up to ileopectinal ligament on either side of symphysis pubis

Question 20

Myomectomy

Answer 20

Removal of fibroids, cervix or abdominally

Question 21

Uterine artery embolization

Answer 21

Alternative to hysterectomy for women with fibroids who dont want to preserve fertility

Question 22

Subtotal hysterectomy

Answer 22

Cervix and its blood supply are retained. reduces risk of damaging bladder and ureters

Question 23

Schauta’s radical hysterectomy

Answer 23

Radicaly hysterectomy- parametrium et al