00:02
gynecologic cancers are often diagnosed
00:04
at a very advanced stage once they have
00:06
already invaded surrounding organs and
00:08
tissue in cases such as this the
00:11
debulking surgery may be the best
00:12
treatment option debulking surgeries are
00:15
performed in an effort to remove as much
00:16
of the tumor as possible with the hope
00:19
of improving patient prognosis and
00:20
making them better candidates for
00:22
chemotherapy many patients with advanced
00:24
ovarian cancer often have severe ascites
00:27
as seen here in this case a large
00:32
malignant tumor was noted to have
00:33
invaded the omentum after blunt
00:43
dissection a vessel sealer was used to
00:46
cauterize a blood supply and then the
00:48
tumor and part of the omentum were
00:51
removed and sent for pathologic
00:52
evaluation
01:02
a Bookwalter retractor was then set up
01:09
to hold the abdominal walls apart the
01:21
uterus ovaries and any overlying tumors
01:23
were then isolated with clamps sharp and
01:28
blunt dissection was used to separate
01:30
the entire specimen from the surrounding
01:32
tissue and then the entire specimen is
01:35
carefully removed from the abdominal
01:37
pelvic cavity a large tumor is seen on
01:42
the right ovary and the body of the
01:44
uterus is noted to be extremely firm to
01:46
palpation when the uterus is cut open
01:56
its body is noted to have a fleshy
01:59
consistency which is suggestive of a
02:01
fibroid however the tumor on the right
02:07
ovary is highly suspicious for
02:09
malignancy
02:20
another tumor was visualized on the
02:22
small intestine after attempting to
02:25
manually dissect it it was determined
02:27
that a small bowel resection would be
02:29
necessary in order to optimally debulk
02:32
the tumor a GI a stapler was first used
02:36
to divide the affected portions of the
02:38
small intestine and once a tumor was
02:48
isolated from the small intestine
02:49
hemostasis was achieved using a large
02:52
vessel cautery device the tumor was then
02:55
removed and sent to pathology
03:06
the remaining end of the small intestine
03:08
are then carefully aligned and
03:10
approximated using multiple alice clamps
03:13
a GI a stapler was then used to create a
03:16
side-to-side and nasty Moses
03:30
prior to closing the anastomosis is
03:33
thoroughly inspected to ensure proper
03:35
alignment