Gynaecology Operations Flashcards
What is done in a Total Abdominal Hysterectomy (TAH)?
Removal of uterus and cervix through abdominal incision
What are specific indications for a TAH?
- ovarian and endometrial cancer
- very large or immobile uterus
How does a subtotal and a TAH differ?
In subtotal hysterectomy the cervix is retained - reduces risk of damage to ureters or bladder
What is a vaginal hysterectomy (VH)?
Removal of the cervix & uterus after incising the vagina from below, the vaginal vault is closed after the operation
What are the specific indications for VH?
- uterine prolapse
What are the two types of laparoscopic hysterectomy done?
- laprascopic assiseted vaginal hysterectomy (LAVH)
- total laprascopic hysterectomy (TLH)
When is laprascopic hysterectomy done?
As alternative to TAH but not as an alternative to VH as if sufficient prolapse then cheaper to do VH
How can a subtotal hysterectomy be done laparoscopically?
Uterine body removed with morcellator instrument
- undertake with care if >40 yr/o with abnormal bleeding as could spread endometrial cancer
What does a Wetheim’s/radical hysterectomy involve?
Removal of parametrium, the upper third of vagina and pelvic lymph nodes
Why would a radical hysterectomy be done?
- usually for cervical carcinoma (stages 1a- 2a)
Can a radical hysterectomy be done vaginally?
Yes - Schautas radical hysterectomy
What are the 2 operations that can be done for CIN?
- LLETZ
- cone biopsy
What is a LLETZ?
Cutting using diathermy under LA to remove the transformation zone of the cervix
What does LLETZ increase the risk of slightly?
Preterm delivery
What is cone biopsy?
Remove the transformation zone and much of the endocervical by making a circular cut with a scalpel or loop diathermy under GA or epidural/spinal
