Re: How to do a hysterectomy
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Dec 19 13:33:48 2007
It is the condition of the ureter that might need repairing that you are
worrying about not the Kidney.
Dan
On Dec 19, 2007 3:17 PM, Dr Eberhard W Lisse <el@lisse.na> wrote:
> My Urologist says the kidneys have 10 days. The previous Urologist
> said something
> similar, but stressed a high index of suspicion.
>
> So, perhaps, the "it's better" might benefit from some evidence :-)-O
>
> el
>
> On Dec 19, 2007, at 20:14, Rafael Haciski wrote:
>
> > But the question hinges on prompt recognition of the problem - it is
> > better to find out in OR while pt is still asleep and correct the
> > problem right there, rather than do it 5 days later, when edema,
> > necrosis, etc set in, and any repair is potentially that much more
> > complicated.
> >
> > Rafael Haciski MD FACOG
> > Anchor Health Centers GYN
> > 800 Goodlette Rd #360
> > 239-643-8780 office
> > 239-571-0292 cell
> > Naples, FL.
> >
> > On Dec 19, 2007, at 12:39 PM, art fougner, md wrote:
> >
> >> I believe Thompson at Emory taught routine post-hysterectomy cysto to
> >> confirm integrity of urinary tract.
> >>
> >> That being said, el does his own sonar so it's not the same as moving
> >> the patient to the ultrasound lab.
> >>
> >> Interesting thread.
> >>
> >> Art
> >>
> >> At Wed, 19 Dec 2007, Joe wrote:
> >>>
> >>> TWO sonograms at $300 each! Versus 10 minute no cost look in
> >>> bladder!
> >>> PULEEZE! Joe C
> >>>
> >>> Dr Eberhard W Lisse wrote:
> >>>
> >>>> Routine cystoscopy? PULEEZE!
> >>>>
> >>>> The MPS (the predominant Malpractice Carrier in the Commonwealth)
> >>>> suggests having
> >>>> a routine post op checkup in place, ie Ultrasound, perhaps on day
> >>>> 5.
> >>>> Preferably with one
> >>>> before the operation to compare. That'll show hydronephrosis, and
> >>>> you
> >>>> have sufficient time
> >>>> for the Urologist to do her thing.
> >>>>
> >>>> Served me well, when one of my patients developed a haematoma on
> >>>> the
> >>>> right side. We saw it
> >>>> waited another day when the hydronephrosis had increased, and we
> >>>> took
> >>>> her to the Operating
> >>>> Theatre where my colleague stented her easily.
> >>>>
> >>>> The results were dramatic, the patient is very happy. The priceless
> >>>> moment was when she said:
> >>>> "Is this what you explained to me at the consent?"
> >>>>
> >>>> On expected difficult pelvic anatomy, previous bladder surgery
> >>>> and such
> >>>> like, and/or if I ask the
> >>>> Urologist to come to the table, I have both urethers stented, after
> >>>> during one case the Urologist
> >>>> casually opened the bladder, put in a small feeding tube and
> >>>> only then
> >>>> could palpate the ureter.
> >>>>
> >>>> I do not think there is a place for chromic any more, in
> >>>> particular
> >>>> since there is rapidly dissolving
> >>>> vicryl.
> >>>>
> >>>> On Dec 19, 2007, at 04:03, Joe wrote:
> >>>>
> >>>>> Steve, I humbly suggest that your legal system is a bit different
> >>>>> than ours. Joe C
> >>>>
> >>>> el
> >>>>
> >>
> >> --
> >> art fougner, md
> >> "May The Wings of Liberty Never Lose a Feather." - Jack Burton
> >
>
--
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
