Te Linde’s Operative Gynecology

Half Title
Title
Copyright
Contributors
	Video Contributors
Preface
Preface From First Edition
Contents
Video Contents List
Section I: Preparing for Surgery
	1 Surgical Anatomy of the Female Pelvis
		The Abdominal Wall
			Skin and Subcutaneous Tissue
			Musculoaponeurotic Layer
			Neurovascular Supply of the Abdominal Wall
			Other Lumbar Plexus Branches
		Vulva and Erectile Structures
			Subcutaneous Tissues of the Vulva
			Superficial Compartment
			Pudendal Nerve and Vessels
			Terminal Branches of Pudendal Nerve
			Autonomic Innervation to Erectile Structures
			Lymphatic Drainage
			Medial Thigh Compartment
		The Pelvic Floor
			Perineal Membrane
			Perineal Body
			Posterior Triangle: Ischioanal Fossa
			Anal Sphincters
			Levator Ani Muscles
		Pelvic Viscera
			Genital Structures
			Lower Urinary Tract
			Sigmoid Colon and Rectum
		Pelvic Connective Tissue
			Uterine Ligaments
			Vaginal Connective Tissue Attachments
			Urethral Support
		Extraperitoneal Surgical Spaces
			Anterior and Posterior Cul-De-Sacs
			Retropubic/Prevesical Space
			Vesicovaginal and Vesicocervical Space
			Rectovaginal Space
			Region of the Sacrospinous Ligament and Greater Sciatic Foramen
		Retroperitoneal Spaces and Lateral Pelvic Wall
			Retroperitoneal Structures Above the Pelvic Brim
			Presacral Space
			Pelvic Retroperitoneal Space
			Lymphatics
	2 Preoperative Care of the Gynecologic Patient
		Assessing Preoperative Surgical Risk
			Patient Characteristics
			Risk Scores
			Procedure-Specific Risk Factors
		Preoperative Testing
			Cardiac Testing
			Chest X-ray
			Complete Blood Count
			Coagulation Testing (PT, aPTT, Platelet Count, INR)
			Electrocardiogram
			Electrolytes and Creatinine
			Liver Function Tests
			Pregnancy Test
			Pulmonary Function Tests
			Type and Screen or Cross
			Repeating Recent Testing
		Preoperative Considerations for COVID19
		Managing Risk Factors: Perioperative Strategies to Prevent Specific Adverse Events
			Major Adverse Cardiac Event
			Infection
			Venous Thromboprophylaxis
			Bowel Preparation
			Hemorrhage and Transfusion
			Chronic Pain Patients
			Management of Perioperative Anticoagulation
			Management of Patients on Chronic Antiplatelet Therapy
		Management of Chronic Medications in the Perioperative Period
			Herbal and Dietary Supplements
		Enhanced Recovery after Surgery Protocols
		Use of Telemedicine in Preoperative Care
Section II: Basic Principles of Gynecologic Surgery
	3 Anesthesia Primer for the Gynecologist
		Basic Anesthesia Concepts
			Anesthesia Care Team
			Standard Anesthesia Monitoring
			The Continuum of Consciousness
		Preoperative Assessment and Optimization
			Risk Assessment
			Airway Evaluation
			Perioperative Fasting Guidelines
			Anesthesia for High-Risk Patients
		Conduct of Anesthesia
			Advanced Monitoring
			General Anesthesia
			Regional Anesthesia
		Fluid Management and Blood Component Therapy
			Perioperative Fluid Administration
			Managing Blood Loss
		Special Considerations for Laparoscopic or Robotic Procedures
			Positioning
			Changes Related to CO2 Insufflation
			Optimizing Ventilation for Laparoscopic and Robotic Surgery
			Perioperative Complications
		Enhanced Recovery Methods
	4 Radiology Primer for the Gynecologist
		Essentials of Imaging
			Ultrasound
			Computer Tomography
			Magnetic Resonance Imaging
			Positron Emission Tomography
			Radiographs
		General Imaging in Gynecology
		Imaging for Developmental Disorders
		Imaging for Acute Pelvic Pain and Abnormal Uterine Bleeding
			Cyst Rupture and Hemorrhagic Cysts
			Ovarian Torsion and Tubal Torsion
			Pelvic Inflammatory Disease and Tuboovarian Abscess
			Endometrial Polyps
			Endometriosis and Adenomyosis
		Imaging Findings for Common Benign Neoplastic Disease Processes
			Fibroids
			Dermoid Cysts
		Imaging Findings of Common Cystic Lesions of Lower Genitourinary Tract
			Urethral Diverticulum
			Vulvar and Vaginal Cysts
		Imaging Findings for Gynecologic Cancers
			Cervical Cancer
			Endometrial and Uterine Cancers
			Vaginal and Vulvar Cancer
			Ovarian Cancer
		O-RADS US and O-RADS MRI Classification System for Adnexal Masses
			Risk Stratification Based on Ultrasound
			Risk Stratification Based on MRI
		Imaging for Complications of Pelvic Surgery
	5 Patient Positioning for Pelvic Surgery
		Incidence of Nerve Injury
			Lower Limb
			Upper Limb
		Basic Neural Anatomy and Relationship to Injury
			Seddon’s Classification of Nerve Injury
			Risk Factors
		Lower Limb
			Lumbosacral Plexus Anatomy
			Proper Positioning to Prevent Nerve Injury
			Clinical Implications and Management
		Upper Limb
			Brachial Plexus Anatomy
			Proper Positioning to Prevent Nerve Image
			Clinical Implications and Management
	6 Surgical Techniques, Instruments, and Suture
		Surgical Instruments
			Scalpels
			Scissors
			Tissue Forceps
			Needle Drivers
			Tissue Clamps
			Other Clamps and Instruments
			Cervical Dilators
			Suction Devices
			Stapling Devices
			Mechanical Hemostatic Devices
			Harmonic Scalpel
			Handheld Retractors
			Fixed Retractors
		Suture
			Natural Absorbable Sutures
			Natural Permanent Sutures
			Synthetic Sutures
			Synthetic Permanent Sutures
			Metal Sutures
			Surgical Needles
			Surgical Knots
		Surgical Techniques
			Dissection Techniques
			Elevate and Incise
			Push and Spread
			Rubbing/Wiping
			Hydrodissection
		Exploration of Pelvic Retroperitoneum
			Dissection of the Pelvic Brim and Pararectal Space
			Ligation of the Internal Iliac (Hypogastric Artery Ligation) and Uterine Arteries
			Dissection of the Presacral Space
			Dissection of the Space of Retzius or Retropubic Space
			Dissection of the Paravesical Space
			Retained Surgical Instruments
	7 Principles of Electrical and Laser Energy Applied to Gynecologic Surgery
		History and the Development of Electrosurgery
		Basic Principles of Electrosurgery
		Electrosurgical Units (Generators)
			Electrosurgical Unit Output
			Dispersive Electrodes (“Return Pads”)
		Electrosurgical Circuits, Waveforms, and Tissue Effects
			Monopolar vs Bipolar Circuits
			Continuous vs Interrupted Waveforms
			Tissue Effects
		Safety Concerns With Monopolar Circuits
			Open Activation
			Direct Coupling
			Insulation Failure
			Capacitive Coupling
			Active Electrode Monitoring
		Argon Beam Coagulator
		Bipolar Instruments
			First Generation
			Second Generation
		Electrosurgical Applications in Operative Hysteroscopy
			Monopolar
			Bipolar
		Ultrasonic Technology
		Laser Technology
			Historical Perspective and Background
			Principles of Laser Technology
			Types and Applications of Lasers
			Laser Safety
		Special Surgical Situations
			Pregnancy
			Body Piercing and Prosthetic Implants
			Implantable Devices
		Hazards of Electrosurgery in the Operating Room
			Fire Hazards
			Surgical Plume
	8 Incisions for Gynecologic Surgery
		Physiology of Wound Healing
			Hemostasis
			Inflammation
			Proliferation
			Remodeling
		Abdominal Incisions
			Transverse Incisions
			Vertical Incisions
		Incisions for Obese Patients
			Midline Incision for the Obese Patient
			Panniculectomy and Abdominoplasty
		Perineotomy Incisions
			Schuchardt Incision
		Closure of Vertical Incisions
			Use of Drains
			Delayed Primary and Secondary Closure
			Negative Pressure Wound Therapy
		Necrotizing Soft Tissue Infections
		Wound Dehiscence and Evisceration
		Incisional Hernia
	9 Principles of Laparoscopy
		Preparation for Laparoscopy
			Patient Selection and Contraindications
			Operating Room Setup
		Laparoscopic Equipment
			Basic Equipment
			Other Laparoscopic Tools
		Peritoneal Entry
			Umbilical Entry
			Palmer Point Entry
			Alternative Entry Sites
		Initial Laparoscopic Entry
			Veress Needle Technique
			Hasson Open Technique
			Optical Direct Entry Technique
			Preoperative Ultrasound Slide-by Test
			Accessory Trocar Placement
			Risks Associated With Entry
		Diagnostic Laparoscopy
		Operative Pelvic Spaces
			Retropubic Space
			Paravesical Space
			Pararectal Space
			Vesicovaginal Space
			Rectovaginal Space
			Presacral/Retrorectal Space
		Tissue Extraction
		Closure
		Complications
			Vascular
			Urinary Tract
			Gastrointestinal
			Nerve Injury
		Special Populations
			Pediatric Patients
			Obese Patients
			Pregnant Patients
			Geriatric Patients
	10 Principles of Robotic Surgery
		Equipment
			Surgeon Console
			Patient-Side Cart
			EndoWrist Instruments
			Vision System
		Port Placement and Docking
		Integrated High-Fidelity Simulator
		Tissue Extraction and Closure
		Role of Robotics in Gynecology
			Suture-Dependent Procedures
			Procedures Requiring Fine Dissection
			Large Patients and Pathology
		Conclusion
Section III: Postoperative Care
	11 Postoperative Care of the Gynecologic Patient
		Immediate Postoperative Care
			Pain Control
			Diet
			Fluids and Electrolytes
			Foley Management
		Intermediate Postoperative Care
			Postoperative Delirium
			Cardiac Complications
			Pulmonary Complications
			Gastrointestinal Complications
			Renal Complications and Electrolyte Imbalances
			Postoperative Transfusion
			Wound Care
			Venous Thromboembolism
	12 Postoperative Infections in Gynecologic Surgery
		Risk Factors for SSI
			Patient-Level Risk Factors
			Procedure-Level Risk Factors
		Evaluation of Surgical Site Infection
			Fever Evaluation
			Physical Examination
			Laboratory Testing
			Imaging
		Postoperative Infection Outside the Surgical Site
			Urinary Tract Infection
			Pneumonia
			Clostridium difficile Colitis
		Treatment of Surgical Site Infection
			Superficial/Incisional Infection
			Deep Incisional Surgical Site Infections
			Organ Space Infections
			Necrotizing Infections
			Vaginal Cuff Infection
		Treatment of Vulvar Infections
		Antibiotic Hypersensitivity
	13 Critical Care of the Gynecologic Patient
		Shock
			Management of Shock
			Hemodynamic Monitoring
			Acid-Base Review
			Use of Vasopressors and Inotropes
		Intravenous Volume Resuscitation
			Fluid Status
			Fluid Choice
			Workup of Oliguria
			Electrolyte Replacement
		Acute Respiratory Distress Syndrome
			Pathophysiology
			Management
		Patient Case Studies
			Patient 1 With Sepsis and ARDS
			Patient 2 With Postoperative Hemorrhage
Section IV: Contemporary Gynecologic Surgical Procedures
	14 Dilation and Curettage
		Indications
		Contraindications
		Preoperative Evaluation
			History
			Physical Examination
			Other Preparation for D & C
			Role of Imaging
			Local Anesthesia
			Regional and General Anesthesia
		D & C Procedure
			Positioning
		Dilation and Curettage
			Pelvic Examination
			Preparation and Visualization
			Cervical Dilation
			Management of a Stenotic Cervix
			Curettage
			Endometrial Biopsy
		Role of Hysteroscopy
		Immediate Complications
			Hemorrhage
			Uterine Perforation
			Cervical Injury
		Delayed Complications
			Hemorrhage
			Infection
			Intrauterine Adhesions
		Management of Anticoagulated Patients
	15 Hysteroscopy
		Instrumentation
			Telescopes
			Camera
			Light Generators
			Diagnostic and Operative Sheaths
			The Flexible Hysteroscope
		Distension Media and Fluid Management
			Liquid Media
			Gaseous Media
		Preoperative Considerations
		Office Hysteroscopy
		Diagnostic Hysteroscopy
		Operative Hysteroscopy
			Electrosurgical Devices and Lasers
		Specific Procedures in Hysteroscopic Surgery
			Hysteroscopic Myomectomy
			Uterine Polyps
			Septate Uterus
			Intrauterine Adhesions
			Cannulation of the Fallopian Tube
			Sterilization
			Endometrial Ablation
			Miscellaneous Procedures
		Complications
			Uterine Perforation
			Management of Fluid Overload
			Intraoperative and Postoperative Bleeding
			Poor Visibility in the Operative Field
			Gas Embolus
			Infection
			Equipment Failure
		Postoperative Considerations
	16 Surgical Management of Abortion and Its Complications
		First Trimester Miscarriage
			Epidemiology of First Trimester Miscarriage
			Diagnosis of First Trimester Miscarriage
			Management of First Trimester Miscarriage
		First Trimester Induced Abortion
			Epidemiology
			Legal Framework for Induced Abortion
			Counseling Prior to Induced Abortion
			Preoperative Evaluation
			Prophylactic Medications for Vacuum Aspiration
			Surgical Uterine Vacuum Aspiration
			Medication Abortion
		Surgical Management of Second Trimester Pregnancy Loss and Induced Abortion
			Epidemiology
			Counseling and Management Options
		Dilation and Evacuation
			Pre-procedure Medications and Preparation
			Dilation and Evacuation Procedure
		Complications of Surgical Abortion
			Immediate Complications
			Delayed Complications
			Late Complications
		Abortion in Highly Restricted Settings
	17 Surgery for Benign Vulvar Conditions
		Vulvar Biopsy
			Punch Biopsy
			Shave Biopsy
			Excisional Biopsy
			Biopsy Complications
			Postoperative Management
		Surgery for Bartholin Gland Abscess and Cyst
			Incision and Drainage Using Word Catheter
			Marsupialization
			Excision
		Ablative Procedures
			Cryotherapy
			Carbon Dioxide Laser
		Surgery for Vestibule Disorders
			Vestibulectomy
		Vulvar Necrotizing Soft Tissue Infections
			Debridement
		Labiaplasty
			Edge Resection Repair
			Wedge Resection Repair
			Postoperative Management
		Perineoplasty
			Revision Perineoplasty
	18 Tubal Sterilization
		Preoperative Evaluation
		Tubal Sterilization Procedures Performed by Minilaparotomy
			Postpartum Tubal Sterilizations
			Interval Tubal Sterilization
			Complications Associated With Sterilization Performed by Minilaparotomy
		Tubal Sterilization Procedures Performed Laparoscopically
		Bipolar Coagulation
			Unipolar Coagulation
			Nonthermal Methods of Tubal Occlusion
			Complications Associated with Laparoscopic Sterilization
		Hysteroscopic Tubal Occlusion
		Bilateral Salpingectomy
			Salpingectomy at Cesarean Section
			Postpartum Bilateral Salpingectomy
			Interval Bilateral Salpingectomy
			Surgical Complications From Bilateral Salpingectomy
		Sterilization Efficacy
		Sterilization Safety
		Long-term and Delayed Complications From Tubal Sterilization
		Menstrual Changes After Sterilization
		Regret
	19 Surgery of the Ovary and Fallopian Tube
		Treatment of Benign Ovarian Masses
			Ovarian Cystectomy
			Oophorectomy
		Adnexal Surgery for Fertility
			Surgery for Tubal Obstruction
			Tubal Reanastomosis
			Ovarian Transposition
			Ovarian Diathermy
	20 Surgical Management of Ectopic Pregnancy
		Epidemiology
			Risk Factors
		Diagnosis
			Presentation
			Ultrasonography
			Serum hCG Testing
			Diagnostic Aspiration
			Diagnostic Laparoscopy
		Tubal Pregnancy
		Cesarean Scar Pregnancy
		Interstitial Pregnancy
		Ovarian Pregnancy
		Cervical Pregnancy
		Abdominal Pregnancy
		Rudimentary Horn Pregnancy
		Heterotopic Pregnancy
		Postoperative Care
	21 Myomectomy
		Classification of Leiomyomas and General Principles of Management
		Preoperative Investigation
		Alternatives to Surgical Excision
		Indications for Surgical Myomectomy
		Preoperative Optimization
		General Principles to Decrease Blood Loss at Myomectomy
		Hysteroscopic Approach to Myomectomy
			Preparation
			General Principles of Hysteroscopic Myomectomy
			Instrumentation
			Operative Approach With Electrosurgical Devices
			Operative Hysteroscopy With Vaporization
			Hysteroscopic Tissue Retrieval Systems (Morcellators)
			Postoperative Recommendations
			Complications After Hysteroscopic Myomectomy
		Laparoscopic Myomectomy
		Robot-Assisted Laparoscopic Myomectomy
		Myomectomy by Laparotomy
		Vaginal Myomectomy
	22 Vaginal Hysterectomy
		Indications
		Historical Perspective
		Preferred Route for Hysterectomy
			Factors That Influence the Route of Hysterectomy
		Preoperative Preparation
		Intraoperative Considerations for Vaginal Surgery
			Basic Surgical Principles
			Technique for Vaginal Hysterectomy
		Special Considerations
			Difficult Anterior Colpotomy
			Cervical Elongation
			Enlarged Uterus
		Adnexectomy at the Time of Vaginal Hysterectomy
			Technique for Salpingo-oophorectomy at Vaginal Hysterectomy
		Complications of Vaginal Hysterectomy
		Postoperative Care
		Hysterectomy Simulation
	23 Abdominal Hysterectomy
		History of Total Abdominal Hysterectomy
		Incidence and Trends
		Indications for Hysterectomy
			Opportunistic Salpingectomy
		Surgical Approach
		Preoperative Evaluation and Management
			Uterine Size
			Medical Management of Preoperative Anemia
		Technique of Abdominal Hysterectomy
		Special Situations
			Supracervical (Subtotal) vs Complete (Total) Hysterectomy
			Appendectomy
			Culdoplasty
			Abdominoplasty
		The Challenging Hysterectomy
			Obliteration of the Cul-de-Sac
			Cervical and Lower Uterine Segment Fibroid
		Postoperative Care
		Reduction of Perioperative Risk
			Ureteral Stents
			Universal Cystoscopy
			Intraoperative Techniques to Reduce Blood Loss
			Prevention of Adhesion
		Risks Associated With Abdominal Hysterectomy
			Transfusion
			Postoperative Infection
			Cuff Dehiscence
			Urinary Tract Injury
			Gastrointestinal Injury
			Complications Related to Adhesion
			Postoperative Neuropathy
			Regret Childbearing/Reproductive Options
			Sexual Function
			Incontinence
			Prolapse
			Menopause
			Effect on Metabolic Disorders and Cardiovascular Disease
			Mortality
			Readmission
			Learners and Hysterectomy
	24 Minimally Invasive Hysterectomy-Laparoscopic and Robotic-Assisted Hysterectomy
		History of Minimally Invasive Surgery
			Total Laparoscopic Hysterectomy
			Laparoscopic Supracervical Hysterectomy
			Robotic-Assisted Laparoscopic Hysterectomy
		Advantages of Minimally Invasive Approach
			Total Laparoscopic Hysterectomy
			Laparoscopic Supracervical Hysterectomy
			Robotic-Assisted Laparoscopic Hysterectomy
		Operative Preparation
			Patient Selection and Preparation
			Patient Positioning
			Robotic Equipment Setup
			Port Placement for Conventional Laparoscopy
			Port Placement for Robotic-Assisted Laparoscopy
			Uterine Manipulation
		Operative Technique
			The Adnexa
			The Uterine Corpus and Vessels
			Colpotomy
			Uterine Extraction
			Morcellation
			Cuff Closure
		Complications
			Cuff Dehiscence
			Wound Complications
			Urologic Injury
		Conclusion
Section V: Gynecologic Oncology
	25 Surgery for Preinvasive Disease of the Cervix
		Ablative Procedures
			Cryotherapy
			Thermal Ablation
			Carbon Dioxide Laser Therapy
		Excisional Procedures
			Cold Knife Conization
			Loop Electrosurgical Excision Procedure
			Postoperative Management
		Comparison of Methods
		Complications
		Dysplasia in Pregnancy
		Information for Patients
	26 Surgery for Preinvasive and Invasive Disease of the Vulva and Vagina
		Surgery for Preinvasive Disease of the Vagina
			Vaginal Biopsy
			CO2 Laser Vaporization
			Vaginectomy
		Surgery for Vaginal Cancer
		Surgery for Preinvasive Disease of the Vulva
			Diagnostic Vulvar Biopsy
			CO2 Laser Vaporization
			Simple Vulvectomy
		Surgery for Vulvar Cancer
			Radical Vulvectomy
			Urethral Resection
			Management of Vulvar Cancer With Perianal Involvement
			Inguinofemoral Lymphadenectomy
			Inguinofemoral Sentinel Lymph Node Mapping
		Ultraradical Surgery for Vulvar Cancer
		Surgery for Less Common Vulvar Malignancies
			Paget Disease of the Vulva
			Malignant Melanoma of the Vulva
			Bartholin Gland Carcinoma
			Basal Cell Carcinoma
			Sarcomas
			Verrucous Carcinoma
		Reconstruction
			Skin Grafts
			Flaps for Reconstruction
	27 Surgery for Uterine Cancer
		Staging
		Prognostic Features
		Endometrial Hyperplasia
		Surgery for Endometrial Cancer
			Perioperative Assessment and Preparation
			Hysterectomy
			Lymphadenectomy
			Minimally Invasive Hysterectomy
			Minimally Invasive Lymphadenectomy
			Sentinel Lymph Node Mapping
		Special Clinical Scenarios
			Surgery for the Morbidly Obese Patient
			Management of Advanced Disease
			Surgery for Young Patients
		Surgery for Type II Endometrial Cancers
		Surgery for Uterine Sarcomas
		Lynch Syndrome
		Undiagnosed Endometrial Cancers
	28 Surgery for Cervical Cancer
		Clinical Presentation
			Impact of Nodal Disease on Survival
		Pretreatment Evaluation and Staging
		Surgical Management of Early Cancer
			Cervical Conization With or Without Lymph Node Assessment
			Simple Hysterectomy With Lymph Node Assessment
			Fertility-Sparing Radical Abdominal Trachelectomy and Conization
		Radical Hysterectomy
			Positioning
			Abdominal Exploration
			Development of Paravesical and Pararectal Space
			Dissection of Hypogastric Artery, Uterine Artery, Bladder, and Ureter
			Dissection of Cardinal Ligament
			Vaginal Closure
			Ovarian Transposition
			Lymphadenectomy
		Postoperative Complications
			Urologic Complications
			Venous Thrombosis and Pulmonary Embolus
			Neuropathy
			Rectal Dysfunction
			Infection
		Pelvic Exenteration
			Positioning and Preparation
			Surgical Approach
		Summary
	29 Surgery for Ovarian Cancer
		Ovarian Cancer
			Risk Factors for Developing Cancer
		Presentation
			Patterns of Spread
		Preoperative Evaluation
		Surgery for Early Ovarian Cancer
		Fertility-Sparing Surgery
		Surgery for Advanced Cancer
			Primary Debulking Surgery
			Exploration
			Pafolacianine
			Resection of Pelvic Tumor and Radical Oophorectomy
			Lymphadenectomy
			Small Bowel and Ileocecal Resection
			Appendectomy and Cancer Debulking
			Resection of Rectosigmoid Colon
			Resection of the Urinary Tract
			Omentectomy
			Resection of Diaphragm Tumor
			Splenectomy
			Liver Resection and Biopsy
			Placement of Intraperitoneal Port
		Minimally Invasive Surgery in Ovarian Cancer
			Laparoscopic Scoring and Assessment
		Neoadjuvant Chemotherapy and Interval Cytoreductive Surgery
		Hyperthermic Intraperitoneal Chemotherapy
		Surgery for Recurrent Disease
		Palliative Surgery for Recurrent Disease
			Management of Bowel Obstruction
			Gastrostomy Tube Placement
		Surgery for Other Ovarian Neoplasms
			Germ-Cell Tumors
			Sex Cord-Stromal Cell Tumors
		Low Malignant Potential Tumors
		Ovarian Cancer Diagnosed in Pregnancy
Section VI: Surgery for Pelvic Floor Disorders
	30 Transvaginal Apical Suspensions for Uterovaginal Prolapse
		Uterine Preservation (Hysteropexy) vs Hysterectomy
		Transvaginal Apical Suspension Procedures
			McCall Culdoplasty
			Uterosacral Ligament Suspension
			Uterosacral Hysteropexy
			Manchester Procedure
			Sacrospinous Ligament Fixation
			Sacrospinous Hysteropexy
			Anterior Vaginal Mesh Colpopexy or Hysteropexy
		Comparative Outcomes
			Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation
			McCall Culdoplasty vs Uterosacral Ligament Suspension or Sacrospinous Ligament Fixation
			Vaginal Hysteropexy Comparative Trials
		Choice of Repair
	31 Sacrocolpopexy
		Introduction: Loss of Apical Support
		Preoperative Considerations
		Coexisting Urinary Incontinence
		Surgical Technique
		Sacrocolpopexy by Open Technique/Laparotomy
			Dissection of the Vagina
			Dissection of the Presacral Space
			Mesh Attachment
		Minimally Invasive Approaches
			Technique Steps for Laparoscopic Sacrocolpopexy
			Technique Steps for Robotic Sacrocolpopexy
			Concomitant Procedures
		Surgical Variations
			Sacrohysteropexy
			Sacrocolpoperineopexy
		Postoperative Considerations
			Outcomes
			Complications
	32 Colporrhaphy and Enterocele Repair
		Anterior and Posterior Vaginal Wall Prolapse
		Symptoms Associated With Vaginal Wall Prolapse
		Anatomy and Function
			Delancey’s Levels of Support
			Support of the Anterior Compartment
			Support of the Posterior Compartment
		Evaluation
			History
			Physical Examination
			Ancillary Testing
		Initial Management
		Surgical Management
			General Considerations
			Procedures for Repair of Anterior Vaginal Wall Prolapse
			Graft Use in the Anterior Compartment
			Procedures for Repair of Posterior Vaginal Wall Prolapse
		Enterocele Repair
			Vaginal Enterocele Repairs
			Abdominal Enterocele Repairs
		Postoperative Care
		Outcomes
	33 Midurethral Slings and Surgery for Stress Urinary Incontinence
		Pathophysiology
		Initial Evaluation
			History
			Physical Examination
			Additional Evaluation of SUI
		Nonsurgical Treatment of SUI
		Surgical Treatment of SUI
			Retropubic Midurethral Sling Procedures
			Transobturator Midurethral Sling
			Complications From Midurethral Slings
			Burch Retropubic Urethropexy
			Pubovaginal Sling
			Urethral Bulking Agents
		Surgical Treatment of Mixed Urinary Incontinence
		Occult SUI
	34 Colpocleisis
		Special Considerations for Obliterative Procedures
		Preoperative Evaluation
			Preoperative Assessment of Older Patients With Pelvic Organ Prolapse
			Endometrial/Cervical Surveillance prior to Le Fort Colpocleisis
			Evaluation for Hydroureter in Patients With Severe Prolapse
			Preoperative Evaluation for Occult Stress Incontinence
		Consideration for Concomitant Hysterectomy
		Le Fort Colpocleisis
		Colpectomy/Colpocleisis
		Concomitant Levator Myorrhaphy and Perineorrhaphy
		Perioperative and Postoperative Considerations
			Complications
			Intraoperative Cystoscopy
			Success/Failure Rates
			Regret/Sexual Function
	35 Vesicovaginal and Rectovaginal Fistula
		Etiology and Epidemiology
			Obstetric Lower Reproductive Tract Fistulas
			Nonobstetric Lower Reproductive Tract Fistulas
		Clinical Presentation
			Vesicovaginal Fistula
			Rectovaginal Fistula
		Diagnosis and Evaluation
			Vesicovaginal Fistula
			Rectovaginal Fistula
		Nonsurgical and Conservative Surgical Management
			Conservative Treatment of Vesicovaginal Fistula
			Conservative Treatment of Rectovaginal Fistula
		Surgical Management
			Perioperative Considerations
			General Principles of Fistula Repair
			Surgical Approach to Repair of Vesicovaginal Fistula
			Surgical Repair of Rectovaginal Fistula
			Tissue Interposition
	36 Repair of Episiotomy and Complex Perineal Lacerations
		Episiotomy
			Incidence
			Indications
			Mediolateral and Midline Episiotomy
			Technique: Mediolateral Episiotomy
			Primary Episiotomy Repair
		Complications of Episiotomy
			Extension
			Hematoma
			Infection and Dehiscence
		Obstetric Anal Sphincter Injuries
			Incidence and Risk Factors
			Technique of Primary Repair
			Postpartum Management of OASIS
			Complications of OASIS
			Delayed Repair of OASIS
Section VII: Complications of Pelvic Surgery
	37 Management of Intraoperative Complications to the Urinary Tract
		Functional Anatomy of the Ureter, Bladder, and Urethra
			Ureter
			Bladder
			Urethra
		Injury to the Ureter in Gynecologic Surgery
			Hysterectomy
			Adnexal Surgery
			Retropubic Surgery
			Surgery for Vaginal Prolapse
			Radical Pelvic Surgery
		Diagnosing Ureteral Injury
			Diagnosis of Intraoperative Ureteral Injury
			Postoperative Diagnosis of Ureteral Injury
		Techniques for Ureteral Repair
			Acute Ureteral Injury
			Ureteroneocystostomy
			Psoas Hitch
			Boari Flap
			Ureteral-Ileal Interposition
		Injury to the Bladder During Gynecologic Surgery
			Hysterectomy
			Retropubic Colposuspension
			Surgery for Prolapse Repair
			Sling Surgery
			Postoperative Diagnosis of Bladder Injury
		Injury to the Urethra During Gynecologic Surgery
	38 Management of Operative Complications to the Gastrointestinal Tract
		Anatomy
			Stomach
			Small Intestine
			Large Intestine
		Enterolysis
		Management of Inadvertent Bowel Injury
			Repair Bowel Enterotomy
			Monopolar and Bipolar bowel injury
		Management of Bowel complications
			Nonmalignant Small Bowel Obstruction
			Malignant Bowel Obstruction
			Fistula
			Radiation Injury
			Bowel Perforation
			Acute Appendicitis
			Ogilvie Syndrome (Colonic Pseudo-obstruction)
		Preoperative Preparation
			Consent
			Stoma Planning
			Nutrition
			Bowel Preparation
			Patient With Bowel Obstruction
		Procedures
			Appendectomy
			Bowel Resection
			Rectosigmoid Colectomy
			Colorectal Anastomosis With a Circular Stapler
			Hand-Sewn Anastomosis
			Anastomosis With a Linear Stapler (Side to Side)
			Ileostomy
			Colostomy
			Loop Ostomy Closure
			End Colostomy Takedown
		Postoperative Care and Complications
			Wound Management
			Small Bowel Anastomosis
			Colorectal Anastomosis
			Intestinal Stomas
			Ostomy Closure
	39 Management of Surgical Hemorrhage
		Surgical Preparation
		Surgical Management of Hemorrhage
			Management of Venous Bleeding
			Management of Arterial Bleeding
			Vascular Ligation Procedures
			Large Vessel Repair
			Packing for Control of Hemorrhage
		Adjuncts to Control of Hemorrhage
			Use of Clips
			Electrosurgery
			Hemostatic Agents
			Vascular Clamp Placement
		Blood Replacement
			Autologous Blood Transfusion
			Blood Product Replacement
			Nonsurgical Interventions for Hemorrhage
			Use of Antifibrinolytic and Other Agents
		Management of Hemorrhage in Minimally Invasive Surgery
		Postoperative Management
		Conclusion
Section VIII: Surgical Management of Selected Gynecologic Conditions
	40 Surgical Management of Pelvic Pain and Endometriosis
		History of Surgery and Pelvic Pain
			Pelvic Adhesive Disease
			Endometriosis
		Surgery for Pelvic Pain
		Surgery for Endometriosis
			Resection of Implants
			Resection of Cul-De-Sac Lesions
			Management of Ovarian Endometriomas
			Resection of Rectal Endometriosis
			Extirpative Resection of Endometriosis
			Resection of Bladder Endometriomas
			Resection of Appendiceal Endometriosis
			Presacral Neurectomy
			Abdominal Wall Endometriosis
			Extrapelvic Endometriosis
		Resection of Ovarian Remnants
		Uterine Suspension
		Uterine and Adnexal Suspension to Prevent Adhesions
	41 Surgical Management of Pelvic Inflammatory Disease
		Etiology and Microbial Epidemiology
		Risk Factors for PID
		Clinical Presentation
		Sequelae of Infection
		Antibiotic Treatment
		Percutaneous Drainage
		Surgical Treatment
			Preoperative Planning
			Intraoperative Management
		Delayed Surgical Management
		Wound Management
		Postoperative Care
	42 Surgical Management of Reproductive Tract Anomalies
		Surgical Management of Reproductive Outflow Tract Anomalies
			Class I Anomalies
			Class II Anomalies
			Class III Anomalies
		Surgery for Nonobstructive Anomalies
			Class I Anomalies
			Class II Anomalies
			Class III Anomalies
			Class IV Anomalies
			Class V Anomalies
			Class VI Anomalies
		Management of Other Outflow Tract Anomalies
		Other Associated Disorders
		Summary
	43 Pediatric and Adolescent Gynecologic Surgery
		Perioperative Care
		Examination Under Anesthesia and Vaginoscopy
		Management of Hymenal Variants
		Management of Genital Injuries
		Laparoscopy in the Pediatric and Adolescent Patient
		Adnexal Surgery
			Preoperative Risk Stratification of Ovarian Masses
			Ovarian Cystectomy
			Paratubal Cysts
			Adnexal Torsion
			Oophoropexy
	44 Surgery for Obstetric Hemorrhage
		General Principles of Management of Obstetrical Hemorrhage
			Early and Comprehensive Assessment
			Timely Intervention
			Adequate Resuscitation
			Communication
			Positioning, Incision, and Exposure
		General Measures to Control Obstetrical Hemorrhage
			Aortic Compression
			Use of Tourniquet
			Pelvic Packing
		Surgical Intervention for Obstetrical
			Uterine Atony
			Hypogastric Artery Ligation
		Surgical Management of Hemorrhage due to Other Causes
			Uterine Rupture
			Uterine Laceration or Extension of Uterine Incision
			Management of a Broad Ligament and Retroperitoneal Hematoma
		Peripartum Hysterectomy
			Hysterectomy for Uterine Atony
			Hysterectomy for Placenta Accreta Spectrum
		Postoperative Care
		Conclusion
Index