Ep. 59 Tackling the Big Uterus with Dr. Uchenna Acholonu

In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman is joined by MIGS specialist Dr. Uchenna Acholonu to discuss the intricacies of complex gynecologic surgeries, focusing particularly on handling large uteruses during total laparoscopic hysterectomy (TLH). --- SYNPOSIS The discussion begins with talk of the doctors’ practices and friendship. They then cover comprehensive patient evaluations and various surgical techniques, including skeletonizing the uterines, colpotomy tricks, uterine manipulators, and morcellation. Dr. Acholonu also shares his personal routines and preferences, including the use of a flexible scope to get around the big uterus. The duo exchange insights on surgical techniques, patient-centered care, and the continuous learning necessary in the medical field. They emphasize the significance of safety, adequate planning, and the benefits of engaging in community networks for better surgical outcomes. The conversation concludes with a light-hearted note on their shared experiences and camaraderie, offering both educational value and a glimpse into the dynamic relationship between two seasoned professionals. --- TIMESTAMPS 00:00 - Introduction 04:01 - Building a Subspecialty Practice 07:34 - Patient Referrals 12:41 - Surgical Approach 16:06- The Big Uterus 28:36 - Surgical Steps in TLH, Skeletonizing the Uterines 32:56 - Challenges and Solutions 36:49 - Energy Sources and Surgical Tools 42:34 - Colpotomy 44:43 - Tissue Extraction and Morcellation 50:27 - Closing and Post-Operative Care 52:05 - Use of Lupron 53:16 - Final Thoughts