Special Surgical Procedures II

LESSON 2: Procedures in Gynecological and Obstetrical Surgery

Section Ii:
vaginal surgery


2-26

[Previous] [Next]

Introduction

 

Table of Contents

 

Search

 

Exercises

 

Courses

 

About this Text

 

Nursing 411

 

Contact Us

 

Links

2-26. SHIRODKAR OPERATION (POSTCONCEPTIONAL)

 

a. General. This operation involves the placement of a collar-type ligature or other material at the level of the internal os to close it. It is made necessary by incompetence of the cervix, a condition characterized by habitual midtrimester spontaneous abortions. The operation is designed to prevent the cervical dilatation that results in release of uterine contents.

 

Figure 2-7. Principles of Shirodkar operation for treatment of

incompetent internal cervical os during pregnancy.

 

b. Operative Procedure (see figure 2-7).

(1) Anterior and posterior vaginal retractors are placed, and the cervix is pulled down with smooth ovum or sponge forceps. With thumb forceps and dissecting scissors, the mucosa over the anterior cervix is opened to permit the bladder to be pushed back.

 

(2) The cervix is lifted, and the posterior vaginal mucosa is similarly incised at the level of the peritoneal reflection. With ligature carriers, the lateral mucosa is tunneled on either side.

 

(3) The prepared ligature is placed at the desired level and anchored posteriorly with silk suture, then drawn tight in front to close the cervix. The suture is tied.

 

(4) The collar ligature is anchored with silk sutures anteriorly. The anterior and posterior mucosal incisions are closed with chromic sutures number 0 or number 2-0 to complete the procedure.

 

 

[Previous] [Next]


These Nursing411 wings incorporate the white heart of international nursing with the
golden wings of an angel, symbolizing Nursing's selfless dedication
to the service of mankind.

The Brookside Associates Medical Education Division  develops and distributes medical information that may be useful to medical professionals and those in training to become medical professionals. This website is privately-held and not connected to any governmental agency. The views expressed here are those of the authors, and unless otherwise noted, do not necessarily reflect the views of the Brookside Associates, Ltd., or any governmental or private organizations. All writings, discussions, and publications on this website are unclassified.

© 2008 Medical Education Division, Brookside Associates, Ltd. All rights reserved

Other Brookside Products

Contact Us

Advertising on this Site