Re: How to do a hysterectomy
From: art fougner, md (evsono@pipeline.com)
Mon Dec 17 11:11:51 2007
Sounds like Porges' Halban technique.
Art
At Mon, 17 Dec 2007, Gerald P. Rodriguez wrote:
>
>I once had the non-pleasure of assisting a much older (this was back in the
>mid 70's) gynecologist in two or three vaginal hysterectomies. He was
>semi-retired having trained and worked for many years in NYC. He did a
>pre-Heaney technique using ligature carriers placing two sutures then
>cutting the pedicles between the sutures. What a bloody tedious mess that
>was! He never held a Heaney clamp in his hands. Does anyone know the name
>for this technique?
>
>Gerald P. Rodríguez, M.D., FACOG
>Santa Fe
>
>>>----- Original Message -----
>From: "ainsron" <ainsron@sbcglobal.net>
>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
>Sent: Monday, December 17, 2007 8:47 AM
>Subject: Re: How to do a hysterectomy
>
>>I do it the same way, Garry.
>>
>> Ronald E. Ainsworth, MD, FACOG
>>
>> -----Original Message-----
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E.
>> Siegel, M.D.
>> Sent: Sunday, December 16, 2007 8:01 PM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: Re: How to do a hysterectomy
>>
>> My 2 cents:
>>
>> I trained at the University of Alabama in the early 80s, with most
>> faculty from there.
>>
>> The "main" technique taught was known as the Heaney one:
>>
>> Enter anteriorly first, then posteriorly, and then use Heaney
>> retractors, Heaney clamps and do the hyst. Dr. Heaney was from
>> Chicago, apparently, as one of our attendings (Thanks, Dr. Hatch) asked
>> that of the residents when they nervously sat it the chair for the first
>> time.
>>
>> One attending at the county hospital taught the "New Orleans" technique:
>>
>> Get in anteriorly, and flip the uterus and start at the fundus and work
>> down.
>>
>> By operating with other practicing physicians who trained elsewhere,
>> I've seen variations on these techniques, and different ways to close
>> the cuff, support the vagina, etc.
>>
>> I really never liked the "New Orleans" techniques, FWIW (sorry, Joe).
>>
>> I still try to get in anteriorly first, but if it doesn't fly, then I go
>> posteriorly as long as possible and try again.
>>
>> Occasionally, I put my finger in posteriorly and try to come around the
>> uterus with my finger to find the anterior entry point (like the
>> pictures in the texts). THAT is not easy to do.
>>
>> Garry
>>
>> --
>> Garry E. Siegel, M.D.
>> Private Practice
>> Roswell, GA
>>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
