Re: How to do a hysterectomy
From: Joe Cutchin (forcep@intercom.net)
Mon Dec 17 09:17:20 2007
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
>
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