Re: How to do a hysterectomy
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Dec 19 12:51:05 2007
I believe he was the Editor of Mattingly when that august text stated that a
cysto should be done at the end of EVERY Hysterectomy.
Dan
On Dec 19, 2007 12:38 PM, art fougner, md <evsono@pipeline.com> 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
