Re: Gyn:  Trachelectomy

From: DoctorJoe@aol.com
Mon Dec 26 20:27:44 2005


In a message dated 12/26/05 2:04:40 PM, l.glazerman@rcn.com writes:

> I don’t disagree with the idea of doing this vaginally, except the concern
> for adhesions, and desire to do appendectomy. This is IMHO, analogous to the
> patient on whom you’re going to do a vag hyst who has significant adhesions,
> in which you do a laparoscopy first.
>

Ditto. The only thing for me - I've always been "happy" to go thru old incisions, esp. Pfannenstiels, and then revise them (even a mini-tummy tuck or some other variation thereof) and make the patient very happy. Adding a few stab wounds here and there in someone with a single (albeit longer) scar already is at least arguably less desireable. One can argue about post-op recovery, but I've not seen problems with repeat transverse incisions - often they hurt a lot less than the first time and if you get over with anesthesia quickly (e.g. 45 minutes instead of maybe 2-3 or more hours?) they wake up "better."

Joe P.





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