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Re: OB didelphyic/bicornuate and breech --> type of incision?From: rmodugno@aol.comMon Jul 28 07:58:04 2008
>----- Original Message ----- From: "Raymond Stephen" <Stephen.Raymond@dhhs.tas.gov.au>? To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>? Sent: Sunday, July 27, 2008 10:18 PM? Subject: Re: OB didelphyic/bicornuate and breech --> type of incision?? ? > If you really were "free to use incisions that work the best for my? > patient, my o.r. crew, and myself" then you would have to acknowledge? > that there may be a conflict between what is best for you patient and? > what is best for you. As I said before a midline in an obese patient is? > definitely not best for her, in obstetrics. I spent much of my time as? > a senior registrar fixing burst abdomens after my consultant had done? > his "best for him" midline incisions.? >? > Steve Raymond? >? ? ***************************
? Ah, Steve, time has passed?since your senior registrar days! Suture materials have changed. ? When I do a midline incision in obese patients ( and that's not all the time!), I have used a mass closure using double-stranded #1 PDS with success. ? So what is the "best" approach to pelvic surgery, OB & GYN, in the obese patient? ? ? Robert Modugno MD MBA FACOG Sylva, NC
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