Re: Gyn: Positive margins on a LEEP

From: Joanne Bulley, MD (islesannie@gmail.com)
Thu Nov 1 06:21:10 2007


Hank that is a good idea - but on this particular patient, it was a REAL B***H to find long skinny retractors to use in the vagina (the regular weighted speculum and Sims retractors were too wide) so that I could reach the cervix to do the LEEP with the long skinny Loop!

So this one gets an Abd Hyst - but for others I will definitely keep your suggestion in mind.

Joanne

At Wed, 31 Oct 2007, Henry Gregor wrote: >
> Joanne,
>
> Why not start vaginally, circumscribe the vaginal cervical margin you want, advance the bladder a bit, then do a culdotomey and then go abdominally to avoid fighting the narrow pelvic archetecture? (I learned this maneuver from Warren Patow, MD former chief at Walter Reed MC, a most amazing surgeon and an even greater gentleman.)
>
> Hank
>
>Tired of spam? Yahoo! Mail has the best spam protection around

--
Joanne Bulley, MD, FACOG
Solo gyn
Keene, NH USA




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