Procedure Ready: Ob/Gyn20 Nov 2017

Before Your First: Hysterectomy

Hysterectomy is one of the most common major surgeries in gynecology. This episode reviews the different surgical approaches, the decision to take or leave the tubes and ovaries, the critical surgical steps – including the four sites of ureteral injury – and key anatomy like the IP ligament, uterine artery, and round ligament.

Show Outline:

Approach – Abdominal, laparoscopic, vaginal, or combination
Tubes and Ovaries – What benefit do they provide? Ovaries still benefit bones and cardiovascular health even after menopause (65yr old cut-off for removal).
Key Surgical Steps
1. Round Ligament – Sampson's artery runs inside
2. IP Ligament (formerly suspensory ligament of the ovary) – Conceals ovarian blood supply from the aorta. If transected before fully sealed, can hemorrhage while retracting into the retroperitoneum.
3. Four Levels of Ureteral Injury – (1) Pelvic brim, (2) medial to IP ligament, (3) under the uterine artery (“water under the bridge”), (4) lateral to vaginal cuff closure
4. Uterine Arteries – Ligate and transect; the uterus should blanch white
5. Colpotomy – Disconnecting the uterus from the vagina
6. Vaginal Cuff Closure – If total hysterectomy

About the Speaker:

Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.

Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.

Denne episoden er hentet fra en åpen RSS-feed og er ikke publisert av Podme. Den kan derfor inneholde annonser.

Episoder(21)

Operative Vaginal Deliveries

Operative vaginal delivery with forceps or vacuum is uncommon but high-stakes. This episode covers the current incidence, indications, consent considerations, preparation checklist, and contraindicati...

9 Jun 202314min

Induction of Labor

Induction of labor is one of the most common procedures on L&D. This episode covers the indications (including the landmark ARRIVE trial for 39-week elective induction), the Bishop score for determini...

9 Jun 202318min

Shoulder dystocia

Shoulder dystocia is an unpredictable obstetric emergency where seconds matter. This episode covers the definition, risk factors, prevention counseling, exactly what you'll see in the delivery room, a...

8 Jun 202317min

Cancer Screening and Vaccinations (HCM)

Cancer screening and vaccinations are essential components of health care maintenance in Ob/Gyn. This episode provides a quick-reference summary of current screening guidelines for cervical, breast, c...

15 Aug 201812min

STIs

Sexually transmitted infections are a core part of gynecologic care. This episode provides a rapid-fire review of the most common STIs organized by diagnostic method – swab/urine vs. serum vs. clinica...

15 Aug 201819min

Before Your First: Colposcopy and LEEP

Abnormal Pap? This episode covers the colposcopy and LEEP procedures from start to finish – why we do them (ASCCP guidelines), the histology and staining principles behind acetic acid and Lugol's iodi...

13 Feb 201815min

Return OB Visits

What happens at every prenatal visit – and what changes as the pregnancy progresses? This episode covers the routine assessments performed at every appointment, plus the key milestones and screenings ...

11 Feb 201813min

First Prenatal Visit

The first prenatal visit sets the tone for the entire pregnancy. This episode walks through everything you'll need to cover – from confirming the pregnancy and dating ultrasound, to screening options,...

8 Feb 201818min