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Read e-book online Advances in Reconstructive Vaginal Surgery PDF

By Robert S. and Zimmerman, Carl W. Kovac

ISBN-10: 0781762359

ISBN-13: 9780781762359

This text/DVD package deal is a step by step, completely illustrated consultant to state of the art concepts in vaginal surgical procedure. The publication info the newest strategies and applied sciences for working throughout the vagina, files the facts helping the vaginal method of such a lot hysterectomies, and describes vaginal reconstructive surgical procedures for correcting many anatomic defects that reason sufferer difficulties. beginning sections evaluation pelvic anatomy and talk about instruments for vaginal surgical procedure, together with antibiotic prophylaxis. next sections specialize in particular surgical procedures, together with hysterectomies, reconstruction of the vagina, and strategies for treating urinary incontinence, colorectal difficulties, and fistulas. the ultimate part discusses acceptance and administration of intraoperative and postoperative issues. A bound-in DVD includes electronic movies of vaginal hysterectomy, fix of the anterior vaginal phase, site-specific colpocleisis, and overall procendentia.

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Extra resources for Advances in Reconstructive Vaginal Surgery

Sample text

The sacral plexus of nerves is a somatic plexus, one on each side of the pelvis, overlying each piriformis muscle. This plexus is located just posterior to the posterior edge of the sacrospinous ligament. Therefore, no sutures or instruments should be placed above the upper edge of the sacrospinous ligament toward the sacrum in order to avoid injuring the sacral plexus of nerves, as well as the inferior gluteal artery, vein, and nerve. The inferior gluteal nerve is directly from the sacral plexus and courses just posterior to the upper edge of the midsegment of the sacrospinous ligament.

A finger in the rectum and use of forceps on the rectovaginal fascia assists the surgeon in determining the proper anatomic reattachment of the rectovaginal fascia. In many cases of posterior vaginal wall prolapse (rectocele), traction toward the ischial spines on the dissected rectovaginal fascia pulls the perineal body and anus to the level of the ischial tuberosities. Occasionally the rectovaginal fascia is detached from the apex of the perineal body and must be reattached. In addition, lateral attachment to the parietal fascia of the levator ani muscles is also indicated.

However, these precautions may not be sufficient to prevent injury to femoral nerves already compromised by subclinical neuropathies or systemic diseases that affect nerve functioning, such as diabetes. The sciatic nerves are relatively fixed anatomically in the gluteal region of the buttocks. ― This is another reason to avoid hyperflexion of the hips and thighs during patient positioning for vaginal surgery. The lateral femoral cutaneous nerve travels laterally, on top of the iliacus muscle and exits the pelvis posterior to the inguinal ligament just medial to the anterior superior iliac spine.

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Advances in Reconstructive Vaginal Surgery by Robert S. and Zimmerman, Carl W. Kovac


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