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Re: How to do a hysterectomy From: art fougner, md (evsono@pipeline.com) Mon Dec 17 19:44:11 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: How to do a hysterectomy" Previous message: Richard Chudacoff: "Re: How to do a hysterectomy" At Mon, 17 Dec 2007, Richard Chudacoff wrote: > >Haha.can't say that has happened, yet I stain the bladder with methylene >blue just in case > >-- >Richard Chudacoff, MD, FACOG > >Las Vegas International Center for Advanced Gynecologic Care > >(Specializing in minimally and non-invasive surgery) > >2481 Professional Court >Las Vegas, NV 89128 > >TEL: 702-485-8893 > >FAX: 702-974-0945 > >www.lasvegasgyncenter.com <http://www.lasvegasgyncenter.com/> > >The information in this e-mail may be confidential and/or privileged. If you >are not the intended recipient or an authorized representative of the >intended recipient, you are hereby notified that any review, dissemination >or copying of this e-mail and its attachments, if any, or the information >contained herein is prohibited. If you have received the e-mail in error, >please immediately notify the sender by return e-mail or phone and delete >this e-mail. Thank you. > > _____ > >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R. Daniel >Braun >Sent: Monday, December 17, 2007 5:14 PM >To: Multiple recipients of list OB-GYN-L >Subject: Re: How to do a hysterectomy > >And once you have sharply entered the bladder, finding the ant. cul-de-sac >becomes a piece of cake. Then you finish your hyst and return and repair the >bladder. Anyone in the room says call the urologist, gets shot. > >Dan > >On Dec 17, 2007 7:59 PM, Richard Chudacoff <rchudacoff@mylinuxisp.com> >wrote: > >Never pushed up the bladder. I was taught that surgeons cut, therefore the >bladder is dissected off the cervix, entered sharply, and then elevated > >Richard Chudacoff, MD, FACOG > >Las Vegas International Center for Advanced Gynecologic Care > >(Specializing in minimally and non-invasive surgery) > >2481 Professional Court >Las Vegas , NV 89128 > >TEL: 702-485-8893 > >FAX: 702-974-0945 > >www.lasvegasgyncenter.com <http://www.lasvegasgyncenter.com/> > >The information in this e-mail may be confidential and/or privileged. If you >are not the intended recipient or an authorized representative of the >intended recipient, you are hereby notified that any review, dissemination >or copying of this e-mail and its attachments, if any, or the information >contained herein is prohibited. If you have received the e-mail in error, >please immediately notify the sender by return e-mail or phone and delete >this e-mail. Thank you. > > _____ > >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of FRANCES >WREN >Sent: Monday, December 17, 2007 4:46 PM > >To: Multiple recipients of list OB-GYN-L >Subject: Re: How to do a hysterectomy > >I just circumscibe the cervix...and push the bladder...and the ureters go >with it...as high up as I can , > >then I go in posteriorly,lift the bladder flap up out of the way with the >heaney retractor and clamp form the posterior enrty to peritoneal cavity >right onto the uterus...below the bladder flap...it is out of the way.... > >then same the other side.. > >and I keep doing that lifting bladder out of the way with retractor...and >making sure it is pushed or indeed sharply dissected if need be , off the >uterus as I go. > >easy peasy usually. > >frances wren > >>>----- Original Message ----- >From: Joe <forcep@intercom.net> >Date: Monday, December 17, 2007 5:21 pm >Subject: Re: How to do a hysterectomy >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> > >> Interesting how we were taught and what we do. I can't conceive >> how you >> can ensure that ureters are out of way by pushing bladder up off >> of >> cervix - even more so with a cystocele present. Joe C >> >> FRANCES WREN wrote: >> >> > I don't do that as a rule ... >> > I push the bladder up and off the cx...and I usually don't >> enter the >> > anterior cul-de-sac...unless I cannot get in posteriorly. >> > then I just clamp and cut and tie all ther way up and usually >> the >> > anterior gets opened as you clamp and cut. >> > I make sure I push the bladder...and therefore ureters well >> off the >> > cervix and out of the way at the beginning I just don't bother >> entering >> > anteriorly. >> > frances wren >> > > >>>> > ----- Original Message ----- >> > From: Joe Cutchin <forcep@intercom.net> >> > Date: Monday, December 17, 2007 9:18 am >> > Subject: Re: How to do a hysterectomy >> > To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >> > >> > > Putting 2 fingers in the anterior opening and spreading >> > > laterally gets >> > > the bladder out of the way. But everyone does that. >> Joe C >> > > >> > > ainsron wrote: >> > > > 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 >> > > > >> > > >> >-- >R. Daniel Braun, MD FACOG(L) CMT >Professor Emeritus >Dept. of Obstetrics and Gynecology >Indiana U. School of Medicine > >R. Daniel Braun > > "Science without Religion is LAME; Religion without Science is BLIND" > Einstein 1941 > -- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton Next message: art fougner, md: "Re: How to do a hysterectomy" Previous message: Richard Chudacoff: "Re: How to do a hysterectomy"

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