Special Surgical Procedures II
LESSON 2: Procedures in Gynecological and Obstetrical Surgery
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Section III. ABDOMINAL GYNECOLOGICAL AND OBSTETRICAL SURGERY
2-35. LAPAROSCOPY (PERITONEOSCOPY, CELIOSCOPY)
a. General. This procedure involves the endoscopic visualization of the peritoneal cavity through the anterior abdominal wall after the establishment of a pneumoperitoneum. It provides the gynecologist the same anatomical view of the pelvic organs as is seen at the diagnostic laparotomy. The pathological condition can be seen, the ancillary procedures such as aspiration of cysts, tubal plastics, and tissue biopsies can be performed. Hemostasis can readily be obtained by using the active electrode probe. This procedure may enable the surgeon to avoid unnecessary pelvic surgery.
b. Preparation of Patient. The patient is placed in the supine position, given general anesthetic, and skin prepped as for a laparotomy. A Foley catheter is inserted, and the table is placed in extreme Trendelenburg position with shoulder braces correctly placed.
c. Operative Procedure.
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