Reconstructive and Reproductive Surgery in Gynecology, Volume 1: Fundamentals and Conditions

Cover......Page 1
Title Page......Page 2
Copyright Page......Page 3
Table of Contents......Page 4
Editors
......Page 6
Contributors
......Page 8
References
......Page 15
Evolving Trends in Gynecology
......Page 12
The Medical Device Industry: Friend or Foe?
......Page 13
Gynecological Surgical Training in the TWENTY-FIRst Century
......Page 14
Surgical Dissection: Theory and Discussion of Techniques
......Page 18
The vagina
......Page 20
The uterine corpus
......Page 21
The uterine cervix
......Page 22
The ovary
......Page 23
The fallopian tube
......Page 24
Innervation of the pelvic viscera
......Page 26
The presacral space
......Page 27
The pelvic brim
......Page 28
The pelvic sidewall
......Page 29
Base of the broad ligament/cardinal ligament: Protect the ureter
......Page 30
Paravesical/obturator space
......Page 31
The vesicovaginal/vesicocervical space
......Page 32
Videos
......Page 33
References
......Page 34
Ovulation
......Page 35
Initiation of menstrual bleeding
......Page 37
Fallopian tube physiology
......Page 38
Physiology of the fallopian tube
......Page 39
Functional deletions
......Page 41
The Endometrium and Embryonic Implantation
......Page 42
Video
......Page 43
References
......Page 45
Historical context
......Page 48
Fundamentals and biophysics of electricity
......Page 49
Cellular and tissue effects of RF electrical energy
......Page 51
RF electrical circuits
......Page 52
Monopolar RF instrumentation
......Page 53
Electrosurgical waveforms: “cut,” “blend,” and “coagulation”
......Page 55
Cutting/vaporization 
......Page 56
Fulguration
......Page 57
Bipolar instrumentation and tissue effects
......Page 58
Hybrid bipolar sealing–cutting devices
......Page 59
Insulation breaks
......Page 60
Capacitive coupling
......Page 61
Dispersive electrode-related injury
......Page 62
Monopolar instruments
......Page 63
Adverse events associated with intrauterine RF electrosurgery
......Page 64
Fundamentals of Ultrasonic Surgery
......Page 65
Conclusion
......Page 66
Videos
......Page 67
References
......Page 68
Consent
......Page 69
Preoperative optimization of the patient
......Page 70
General considerations
......Page 71
Leg positioning
......Page 72
Preinsufflation
......Page 73
Comparison of access techniques
......Page 77
Accessory ports
......Page 78
Previous abdominal surgery
......Page 80
Pregnant patients
......Page 81
Insufflation systems
......Page 82
Video imaging systems
......Page 83
Ancillary laparoscopic instruments for tissue manipulation
......Page 84
Cutting and hemostasis
......Page 85
Radiofrequency electricity
......Page 86
Monopolar instruments
......Page 87
Ultrasonic energy
......Page 88
Laparoscopic suturing
......Page 89
Manual morcellation
......Page 90
Fascial closure
......Page 91
Discharge instructions
......Page 92
Signs of complications
......Page 93
Videos
......Page 94
References
......Page 95
Introduction
......Page 99
Basic set up for the da Vinci surgical system
......Page 100
Disadvantages
......Page 101
Firefly fluorescence imaging
......Page 102
Uterine manipulation
......Page 103
Specialized laparoscopic ports
......Page 104
Single-site
......Page 105
Vessel-sealing devices
......Page 106
The future of microprocessor-assisted laparoscopic surgery
......Page 107
Videos
......Page 109
References
......Page 111
Patient selection and preparation
......Page 113
Prophylactic antibiotics
......Page 114
Surgeon position and ergonomics
......Page 115
Midline incision
......Page 116
Pfannenstiel incision
......Page 117
Cherney’s incision
......Page 118
Minilaparotomy incisions
......Page 119
Local anesthesia for abdominal incisions
......Page 120
Creation and optimization of the operative field
......Page 121
Uterine manipulation
......Page 122
Suction irrigation systems
......Page 123
Introduction
......Page 124
Radiofrequency (RF) electrical energy
......Page 125
Needles
......Page 126
Synthetic absorbable sutures
......Page 127
Synthetic nonabsorbable sutures
......Page 128
Knots
......Page 129
Needle drivers and other suturing instruments
......Page 130
Fascial closure
......Page 131
Signs of complications
......Page 132
References
......Page 133
Introduction
......Page 138
Endoscopes and sheaths
......Page 139
Light sources and cables
......Page 140
Systems for uterine distension
......Page 141
Electrosurgical instruments
......Page 142
Instruments for specimen extraction
......Page 143
The hysteroscopy core competencies
......Page 144
Patient counseling: The informed consent process
......Page 145
Equipment orientation
......Page 146
Operator orientation
......Page 147
Uterine anesthesia
......Page 148
Ancillary techniques
......Page 149
Visualization and imaging
......Page 150
Postoperative care
......Page 151
Videos
......Page 152
References
......Page 154
Basic ultrasound physics
......Page 156
Contrast hysterosonography
......Page 157
Magnetic resonance imaging
......Page 158
Terms and definitions for description, documentation, and reporting of the endometrium and myometrium by ultrasonic and MRI techniques
......Page 159
Adnexal torsion
......Page 162
Paraovarian cysts
......Page 164
Ultrasound
......Page 165
Endometrial Polyps
......Page 166
Ultrasound and leiomyomas
......Page 167
Leiomyoma mapping
......Page 169
MRI and TVUS for the diagnosis of leiomyosarcoma
......Page 170
Transvaginal sonographic features of adenomyosis
......Page 171
Junctional zone changes (MRI and 3D TVS)
......Page 173
Ultrasound and endometriomas
......Page 174
MRI and endometriomas
......Page 175
Ultrasound evaluation of deep infiltrating endometriosis
......Page 176
MRI and DIE: General aspects
......Page 177
MRI and DIE: Site-specific findings
......Page 178
MRI and TVUS in endometriosis
......Page 179
Hystero-Salpingo-Contrast-Sonography
......Page 180
Coded contrast 3D HyCoSy
......Page 181
General considerations
......Page 182
Müllerian agenesis and uterine hypoplasia (AFS Class I or ESHRE Class U5)
......Page 183
Unicornuate uterus (AFS Class II or ESHRE Class U4)
......Page 184
Septate uterus (Class V AFS or Class U2 ESHRE/ESGE)
......Page 185
Dysmorphic uterus (Class U1 ESHRE/ESGE)
......Page 186
Videos
......Page 187
References
......Page 188
Postoperative adhesions
......Page 196
Abortion and infertility
......Page 197
Reducing the risk of intrauterine synechiae
......Page 198
Ovarian surgery
......Page 199
Tubal pregnancy
......Page 200
References
......Page 202
Introduction
......Page 204
Recognition
......Page 205
Infectious adverse events
......Page 206
Risk-reducing measures
......Page 207
Management
......Page 208
Management
......Page 209
Ureter
......Page 210
Recognition
......Page 211
Recognition
......Page 212
General technique and risk-reducing measures
......Page 213
Risk-reducing measures
......Page 214
Risk-Reducing measures
......Page 215
Patient positioning
......Page 216
Distending media
......Page 217
Management
......Page 218
Causes/mechanisms of hemorrhage
......Page 219
Risk-reducing measures
......Page 220
Management
......Page 221
Risk-reducing measures
......Page 222
Gastrointestinal events
......Page 223
Risk-reducing measures
......Page 224
Videos
......Page 225
References
......Page 226
Urogenital system
......Page 231
Incidence and prevalence
......Page 232
Impact on fertility and other associations
......Page 233
Diagnosis
......Page 234
Diagnosis
......Page 237
Management
......Page 238
Diagnosis
......Page 239
Diagnosis
......Page 240
Management
......Page 241
Incidence
......Page 242
Diagnosis
......Page 243
Conclusion
......Page 244
References
......Page 245
Epidemiology, pathogenesis, and clinical impact
......Page 248
The role of β-hcg and transvaginal ultrasound
......Page 249
The role of endometrial sampling
......Page 250
The role of laparoscopy for diagnosis of ectopic pregnancy
......Page 251
Cervical pregnancy
......Page 252
Abdominal pregnancy
......Page 253
Expectant management
......Page 254
Medical treatment (systemic)
......Page 255
Medical treatment (local)
......Page 257
Surgical treatment
......Page 259
References
......Page 260
Prevalence
......Page 264
Risk factors for endometrial polyps
......Page 265
Endometrial polyps and malignancy
......Page 266
Diagnosis of endometrial polyps
......Page 267
Conclusion
......Page 268
References
......Page 270
Introduction/Definitions
......Page 274
Potential Pathogenesis
......Page 275
Clinical presentation
......Page 276
Therapeutic approaches: General Considerations
......Page 277
Valproic acid
......Page 278
Uterus-sparing surgical treatment
......Page 279
Intraoperative
......Page 280
Classic technique
......Page 281
Transverse H-incision technique
......Page 282
Wedge resection of the uterine wall
......Page 283
Non-excisional techniques
......Page 284
Conclusions
......Page 285
Videos
......Page 286
References
......Page 288
Endometriosis subtypes
......Page 292
Extrapelvic endometriosis
......Page 293
Pathogenesis
......Page 294
History
......Page 295
Biomarkers
......Page 296
General concepts
......Page 297
Danazol
......Page 298
Dienogest
......Page 299
GnRH agonists
......Page 300
Medical therapy as an adjunct to surgery
......Page 301
Surgical management of ovarian endometriomas
......Page 302
Medical therapy: conclusions
......Page 303
In vitro fertilization and embryo transfer
......Page 304
Videos
......Page 305
References
......Page 306
Prevalence
......Page 311
Etiology and pathogenesis
......Page 312
FIGO classification
......Page 313
Abnormal bleeding
......Page 314
Natural history of leiomyoma growth
......Page 315
Leiomyosarcoma
......Page 316
Imaging
......Page 317
Gonadotropin-releasing hormone agonists
......Page 318
Gonadotropin-releasing hormone antagonists
......Page 319
Mifepristone
......Page 320
Androgen therapy
......Page 321
Conclusions
......Page 322
References
......Page 325
Normal pelvic floor function
......Page 333
Lower urinary tract function
......Page 334
Anorectal function
......Page 335
Connective tissue support
......Page 336
Disorders of storage; urinary incontinence
......Page 337
Anatomical defects
......Page 339
Disordered defecation
......Page 340
Fecal incontinence
......Page 341
Epidemiology and pathophysiology of pelvic organ prolapse
......Page 343
Conclusions
......Page 344
References
......Page 345
Risk factors and risk markers
......Page 348
Pathogenesis
......Page 349
Endometrial biopsy
......Page 350
Antimicrobial treatment
......Page 351
Control strategies
......Page 352
Future prospects
......Page 353
References
......Page 356
Proximal tubal occlusion
......Page 358
Histology
......Page 359
Etiology
......Page 360
Distal tubal disease and occlusion
......Page 361
Congenital abnormalities
......Page 362
Tuberculosis
......Page 363
Tubal polyps
......Page 364
References
......Page 366
Introduction
......Page 369
Postoperative adhesion formation and Infertility
......Page 370
Microsurgery and microsurgical tenets
......Page 371
The function of the peritoneal cavity
......Page 372
Local factors that delay the repair of surgical lesions
......Page 373
Factors in peritoneal fluid delay repair and enhance adhesion formation at surgical lesion sites
......Page 374
Keep opposing lesions separated for 5 days
......Page 376
Prevent mesothelial cell trauma and acute inflammation of the entire peritoneal cavity
......Page 377
Peritoneal conditioning to prevent mesothelial cell retraction and acute inflammation
......Page 378
The broader picture: Inflammation of the Peritoneal Cavity, Postoperative Pain, Postoperative Ileus, and Postoperative Fatigue Syndrome
......Page 379
Conclusions and discussion
......Page 380
References
......Page 383
Asherman syndrome
......Page 390
Pathogenesis
......Page 391
Hysterosalpingography
......Page 392
Hysteroscopy
......Page 396
Primary prevention of IUA after postpartum procedures
......Page 397
Pregnancy rates and live birth rate
......Page 398
Complications of post IUA pregnancies
......Page 399
References
......Page 400
Cervical cancer
......Page 403
Ovarian cancer
......Page 404
Prevention of cervical cancer
......Page 405
Screening for cervical cancer; Management of preinvasive disease
......Page 406
Prevention of ovarian cancer
......Page 407
The role of salpingectomy in the prevention of ovarian cancer
......Page 408
Prevention of endometrial cancer
......Page 409
Borderline tumors of the ovary
......Page 410
Post-treatment surveillance
......Page 411
Menopausal hormone therapy (MHT) in cancer patients
......Page 412
Gestational trophoblastic neoplasia
......Page 413
Cancer therapy
......Page 415
Pregnancy after cancer
......Page 416
References
......Page 419
Introduction
......Page 426
History and physical examination
......Page 427
Primary dysmenorrhea
......Page 433
Ovarian remnant syndrome and ovarian retention syndrome
......Page 435
Vulvar causes: Provoked vulvodynia or vestibulodynia
......Page 436
Pelvic congestion syndrome
......Page 437
Musculoskeletal pain syndromes
......Page 438
Gastrointestinal causes of chronic pelvic pain
......Page 439
Bladder pain syndrome (interstitial cystitis)
......Page 440
Pudendal neuralgia
......Page 442
Conclusions
......Page 443
References
......Page 444
Chapter 24: Abnormal uterine bleeding
......Page 448
Physiology of Menstruation
......Page 449
Adenomyosis (AUB-A)
......Page 450
Ovulatory disorders (AUB-O)
......Page 451
Endometrial disorders (AUB-E)
......Page 452
Clinical evaluation
......Page 453
Conjugated equine estrogens
......Page 454
Evaluation of Women with Chronic AUB in the Reproductive Years
......Page 455
Treatment options for women with chronic AUB
......Page 456
Surgical management
......Page 458
Progesterone receptor modulators (PRM)
......Page 459
Endometrial ablation for AUB-LSM
......Page 460
Medical management
......Page 461
Implantable progestins
......Page 462
What Is the risk of endometrial cancer?
......Page 463
Transvaginal ultrasound (TVUS)
......Page 464
Sequencing investigations
......Page 465
Recurrent spontaneous or breakthrough bleeding
......Page 466
Summary
......Page 467
References
......Page 468
Non-neoplastic adnexal masses
......Page 476
Arising from the fallopian tube
......Page 477
Clinical evaluation
......Page 478
Tumor markers
......Page 479
Management of the presumed benign cystic adnexal mass
......Page 480
The pregnant patient
......Page 482
Summary and conclusions
......Page 483
References
......Page 486
Genital and sexual symptoms
......Page 488
Prolapse evaluation
......Page 489
POP classifications
......Page 490
Urodynamic investigations
......Page 491
Pelvic floor muscle training
......Page 492
Introduction
......Page 493
Bladder diary
......Page 494
Dietary fluid management
......Page 495
Intradetrusorial Botox® Injections
......Page 496
Conclusion
......Page 497
References
......Page 498
Initial Assessment
......Page 501
Diagnostic evaluation techniques
......Page 502
Assessment for uterine anomalies
......Page 503
Hysteroscopy
......Page 504
Hysterosalpingography
......Page 505
Selective salpingography
......Page 509
Tubal cannulation
......Page 510
Laparoscopy
......Page 515
Summary
......Page 518
References
......Page 519
Recurrence risk
......Page 521
Etiologies, diagnosis, and treatment of RPL
......Page 522
Intrauterine adhesions
......Page 523
Luteal phase deficiency
......Page 524
Antiphospholipid antibody syndrome (APS)
......Page 525
Parental chromosomal disorders
......Page 526
Preimplantation genetic testing
......Page 527
Outcome
......Page 528
References
......Page 529
Index
......Page 533