Re: How to do a hysterectomy
From: Dr Eberhard W Lisse (el@lisse.na)
Wed Dec 19 13:16:43 2007
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
>
