Contents

1. Pre- and Postoperative Management and Therapy of Acute Complications 1.1

Pre- and Postoperative Management 1.1 Infections 1.18 Instrumentation 1.2 Ileus, Peritonitis, and Dehiscence 1.19 Preventive Measures 1.2 Ileus 1.19 Therapy of Acute Complications 1.3 Peritonitis 1.20 Intraoperative and Postoperative Hemorrhage 1.4 Dehiscence and Evisceration 1.21 Intraoperative Bleeding 1.4 Pulmonary Complications 1.22 Postoperative Bleeding 1.5 Pulmonary Embolism and Infarction 1.22 Internal Iliac Artery Ligation 1.5 Aspiration, Atelectasis, and Bronchopneumonia 1.22 Acute Cardiovascular Collapse 1.6 Aspiration 1.22 Shock 1.12 Atelectasis 1.23 Hypovolemic Shock 1.13 Therapy 1.23 Septic Shock •.-.-.- 1.16 References 1.23

Minor Procedures and Abdominal Wall Surgery

2. Minor Diagnostic and Therapeutic Procedures 2.1

Dilatation and Curettage 2.1 Cautery and Conization 2.17 : 2.1 Cryosurgery 2.18 Curettage 2.2 Laser Surgery 2.18 Treatment of Intrauterine Synechiae 2.5 Cervical Amputation 2.19 Tests of Tubal Patency 2.6 Trachelorrhaphy (Emmet Operation) and Repair Tubal Insufflation 2.6 of Cervical Lacerations 2.20 Hydrotubation 2.6 Cervical Polypectomy 2.20 2.6 Cervical Biopsy 2.20 Celioscopy .; 2.7 Cold-Knife Conization, Ring Biopsy, and Endocervical Laparoscopy ; 2.7 Curettage 2.21 2.15 Surgery on and Introitus 2.23 , Posterior Colpotomy, and Parametrial Biopsy. 2.15 Biopsy 2.23 Puncture of the Cul-de-sac of Douglas 2.15 Ablation of Condylomata 2.23 Posterior Colpotomy 2.16 Procedures for Bartholin Cyst or Abscess 2.23 Needle Biopsy of the 2.17 References 2.25 Operations on the 2.17

3. Sterilization and Pregnancy Termination 3.1

Operative Sterilization in the Female 3.1 First Trimester Abortion 3.12 versus 3.1 Menstrual Extraction by Karman Method 3.12 Tubal Sterilization 3.1 Interruption of Pregnancy to Twelve Weeks 3.13 Partial Resection of the Tubes 3.3 Evacuation by Curettage 3.13 Mechanical Occlusion of the Tubes with Clips 3.13 or Silastic Rings 3.7 Second Trimester Abortion 3.14 LaparoscopicTubal Sterilization 3.9 Abortion and Sterilization 3.16 Tubal Sterilization by Minilaparotomy 3.10 Risks and Complication of Legal Abortion ..'...• 3.16 Vaginal Tubal Sterilization 3.10 References 3.17 Pregnancy Termination 3.12

http://d-nb.info/841041237 VIII Contents

4. Surgery on the Abdominal Wall 4.1 General Remarks 4.1 Drainage 4.16 Laparotomy Incisions Applicable to Gynecologic Procedures . 4.3 Complications of Wound Healing 4.17 Vertical Midline Incision 4.3i Hemorrhage (Hematoma) and Infection (Abscess) 4.17 Pfannenstiel Transverse Fascial Incision •. 4.8 Dehiscence 4.17 Transverse Fascial Incision, Cohen Modification 4.11 Intestinal Fistulas 4.18 Minilaparotomy Incision 4.15 Peritoneal Adhesions 4.18 Paramedian Incision 4.16 Unexpected Findings 4.19 Lateral McBurney Incision 4.16 References 4.19 Reexploration 4.16

5. Surgery for Abdominal Wall Hernias 5.1 General Considerations 5.1 Female Hydrocele 5.9 Inguinal Hernia 5.1 Umbilical Hernia 5.9 Lateral or Indirect Inguinal Hernia 5.1 Ventral Hernias 5.10 Medial or Direct Inguinal Hernia 5.5 Abdominal Plasty (Dermolipectomy) 5.11 Femoral or Crural Hernia 5.5 References 5.16

Abdominal Operations

6. Abdominal Procedures for Genital Displacement. 6.1

Uterine Retroflexion and Descensus 6.1 Post-Hysterectomy Vaginal Prolapse 6.6 Hysteropexy (Kocher Method) 6.2 Ventral Fixation of the Vaginal Stump 6.6 Uterosacral Ligament Plication 6.2 Sacral Suspension of the 6.9 Round Ligament Shortening 6.2 Excision of the Cul-de-sac Peritoneum 6.9 Pestalozza Ventral Fixation Method 6.6 Uterine Inversion 6.10 Ovarian Prolapse 6.6 References 6.10

7. Surgery on the 7.1

Abdominal Hysterectomy 7.1 Results, Complications, and Errors 7.20 Following Hysterectomy 7.2 Abdominal Myomectomy 7.20 Total Hysterectomy 7.2 Surgery for Uterine Malformation 7.25 Extrafascial Hysterectomy 7.3 Metroplasty ". 7.26 Intrafascial Hysterectomy, Aldridge Method 7.12 References 7.29 Subtotal or Supracervical Hysterectomy 7.17

8. Abdominal 8.1 Cesarean Section 8.1 Extraperitoneal Cesarean Section 8.15 Cesarean Hysterectomy 8.12 References 8.17

9. Adnexal Surgery. 9.1 General Remarks 9.1 Ovarian Tumors 9.4 Adnexal Inflammation 9.1 Tumors of the 9.8 Genital Tuberculosis 9.1 Surgical Procedures 9.9 9.2 Ovarian Wedge Resection 9.9 Ectopic Pregnancy 9.3 Cyst Resection 9.9 Tubal Pregnancy 9.3 Oophorectomy 9.10 Ovarian and Rudimentary Horn Pregnancy 9.4 Extirpation of an Intraligamentous Cyst 9.10 Abdominal Pregnancy 9.4 9.10 Contents IX

Salpingotomy and Other Conservative Procedures 9.11 3. "Open" Interstitial Anastomosis 9.23 Salpingo-oophorectomy 9.12 4. Tubouterine Implantation at the Uterine Cornu 9.24 Surgery for Pelvic Inflammatory Disease 9.14 Indications 9.24 Excision or Cauterization of Endometriotic Foci 9.16 5. Uterotubal Implantation at the Posterior Uterine Wall .. 9.25 Surgery for Pelvic Varicocele 9.16 6. Lysis of Adhesions 9.26 Infertility Surgery 9.17 7. Fimbrioplasty (Fimbriolysis) 9.26 Nonsurgical Treatment Methods 9.20 8. Salpingostomy (Salpingoneostomy) 9.26 Surgical Methods 9.20 9. Procedure for Irreversible Tubal Damage 9.28 1. Tubal Anastomoses (Tubotubal or End-to-End Results of Infertility Surgery 9.28 Anastomoses) 9.20 Surgery for Endometriosis 9.29 2. Interstitial Anastomosis (Tubocornual Anastomosis) .. 9.22 References 9.29

10. Surgery for Pelvic Pain 10.1 Presacral Neurectomy (Cotte Method) 10.2 Ovarian Denervation 10.4 ExtendedPresacralNeurectomy(HeldlandVaraMethods) .. 10.4 References 10.4 Sacral Denervation (Thiermann Method) 10.4

11. Bowel Surgery 11.1 Appendectomy 11.1 Fecal Fistula 11.5 McBurney Incision 11.1 Colostomy 11.6 Technique of Appendectomy 11.2 Reversing a Colostomy 11.6 Resection of Meckel's Diverticulum •..-,.„ .. 11.4 Bowel Resection and Anastomosis 11.9 Management of Bowel Injuries 11.5 Resection and Anastomosis of the Large Bowel 11.10 Enterostomies 11.5 References 11.13

Vaginal Operations

12. Vaginal Hysterectomy and Vaginal Procedures for Descensus 12.1 Vaginal Hysterectomy 12.6 Operations 12.54 Vaginal Procedures for Genital Descensus 12.27 Therapy for Prolapsed Vagina (Posthysterectomy) 12.58 Vaginal Hysterectomy with Anterior and Posterior Colpohysterectomy, Colpectomy 12.63 Vaginal Plasty 12.28 Additional Procedures for Prolapse 12.67 Manchester Operation 12.48 References 12.70

13. Vaginal Operations on the Uterus and Adnexa (Unassociated with Prolapse). 13.1 Extirpation of the Cervical Stump 13.1 Vaginal Tubal Sterilization 13.10 Vesicofixation of the Uterus 13.4 Surgery for Cervical Incompetence 13.10 Vaginal Hysterotomy 13.4 Shirodkar Cerclage 13.10 Vaginal Procedure for Uterine Inversion 13.8 Lash Isthmorrhaphy 13.14 Severing the Uterosacral Ligaments for 13.10 References 13.16

14. Vulvar and Vaginal Operations 14.1 Injuries 14.1 Carcinoma in the Vaginal Cuff 14.10 Minor Surgery 14.1 Surgery for Female Hermaphroditism 14.11 Denervation of the Vulva for Pruritus 14.1 Labial agglutination 14.11 14.3 Clitoral hypertrophy and labial fusion 14.11 Operations for Vaginal and Vulvar Septum, Atresia, Surgery for Congenital Cloaca and Anal Atresia 14.14 and Stenosis 14.6 Surgery for Vaginal Atresia and Imperforate hymen and hymenal reconstruction 14.6 Acquired Vaginal Obliteration 14.14 Vaginal septum 14.6 Techniques in the absence of a uterus 14.14 Congenital atresia and vaginal stenosis 14.6 . Free skin graft for lining the neovagina 14.20 Acquired vaginal atresia and stenosis 14.9 Methods for cases with a functional uterus 14.26 Operation for Vaginal Cysts and Myomas 14.9 References 14.27 Contents Radical and Ultraradical Cancer Operations

15. Surgery for Cervical and Uterine Malignancies. 15.1 Cervical Carcinoma --,-./.. 15.1 Other Uterine Malignancies 15.8 Preinvasive lesions 15.1 Sarcomas 15.8 Invasive cervical carcinoma 15.1 Gestational TrophoblasticTumors 15.9 Early invasive carcinoma of the cervix 15.3 Abdominal surgery for cervical carcinoma 15.9 Invasive cervical carcinoma 15.3 Modified radical hysterectomy 15.12 Endometrial Carcinoma 15.5 Radical hysterectomy 15.12 Adenomatous and atypical adenomatous hyperplasia .... 15.6 Vaginal Surgery for Cervical Carcinoma 15.34 Invasive endometrial carcinoma 15.6 References 15.49

16. . 16.1 General Remarks 16.1 Colostomy 16.19 Pelvic Exenteration, Bricker-Morley Technique 16.3 Urinary conduit 16.21 Fecal and Urinary Diversion 16.19 References 16.22

17. Vaginal and Vulvar Carcinoma. 17.1

Vulva Carcinoma 17.1 Carcinoma of Bartholin's gland 17.14 Preinvasive carcinoma 17.1 Vaginal Carcinoma 17.14 Invasive carcinoma 17.1 Carcinoma in situ 17.14 Other Vulvar Malignancies 17.14 Invasive carcinoma 17.14 Malignant melanoma 17.14 References 17.15 Urethral carcinoma 17.14

18. Breast Surgery 18.1

Anatomical considerations 18.1 Mastectomy 18.19 Biopsy 18.2 Breast carcinoma 18.19 Needle aspiration or biopsy 18.2 Total mastectomy with axillary lymphadenectomy 18.23 Excision biopsy 18.3 Modified radical mastectomy, Patey technique 18.28 Excision of breast lobule or duct 18.7 Classic radical mastectomy, Halsted-Rotter method 18.29 Inframammary biopsy 18.9 Total mastectomy ;.... 18.30 Subcutaneous Mastectomy and Plastic Augmentation 18.10 Procedures to preserve the breast 18.30 Procedure for normally shaped breasts 18.10 ComplicationsandErrors 18.31 Surgery in ptotic breasts 18.16 Results 18.32 Surgery in hypertrophic breasts 18.17 Augmentation Mammoplasty 18.33 Surgery for Mastitis 18.18 Reduction Mammoplasty 18.38 Acute mastitis 18.18 References 18.46 Chronic mastitis 18.18

Urologic and Proctologic Procedures

19. Urinary Operations 19.1

Urethra 19.1 Bladder Neck Obstruction 19.7 Skenitis 19.1 Bladder 19.8 Urethral Caruncle and Urethral Polyp 19.1 Cystitis 19.8 Urethral Prolapse 19.2 Urinary Incontinence 19.8 Urethral Diverticulum 19.2 Disorders of Bladder Emptying and Bladder Drainage 19.8 Urethral Stenosis 19.5 Bladder injuries 19.12 Contents XI

Ureter ' 19.14 Ureterosigmoid Urinary Diversion 19.32 End-to-End Anastomosis 19.15 Urinary diversion 19.35 Ureterovesical implantation 19.17 Urinary Diversion by Sigmoid Conduit 19.36 Boari plasty 19.23 Urinary Diversion by Transverse Colon Conduit 19.39 Ureteroureterostomy 19.26 Revision of Urinary Diversion 19.41 Transureteroureterostomy 19.27 Kidney /. 19.42 Ileum conduit for ureteral implantation 19.28 Nephrostomy 19.42 Ureterocutaneous anastomosis 19.28 References 19.44 Synthetic ureteral prosthesis 19.32

20. Fistulas of the Lower Urinary Tract 20.1. Vesicovaginal and Vesicocervical Fistulas 20.1 Urethrovaginal Fistula and Urethroplasty Operation 20.15 Vaginal Operation 20.2 Urethrovaginal Fistula 20.15 Suprapubic Operation 20.8 Urethroplasty Operation 20.15 Vesicocervical Fistulas 20.14 20.20 Methods for Closure in Extreme Cases ,,...' 20.14 References 20.21

21. Surgery for Stress Incontinence 21.1 Bladder Sphincter Insufficiency 21.1 Cystourethropexy 21.8 Preoperative Evaluation: Degree of Incontinence 21.2 Urethrovesical Suspension 21.11 Treatment of Stress Incontinence 21.3 Sling Operation 21.14 Conservative Management 21.3 Abdominoperineal Urethral Suspension 21.22 Surgical Measures 21.3 Suburethral Teflon Injection 21.23 Common Operations for Incontinence 21.4 Summary of Results for Incontinence Operations 21.23 Anterior Colporrhaphy 21.4 References 21.24

22. Surgery for Rectovaginal Fistulas and Complete Perineal Lacerations 22.1 Rectovaginal Fistulas 22.1 References 22.8 Complete Perineal Lacerations 22.5

23. Proctological Surgery. 23.1 Pruritus Ani 23.3 Chronic Anal Fissures 23.4 Fecal Incontinence 23.3 Hemorrhoids and Anal Prolapse 23.5 Perineal Laceration or Incision 23.3 Rectal Prolapse 23.8 Exposing Anorectal Fistulas 23.3 References 23.8 Anorectal Abscesses and Fistulas 23.4

General References. xm

Index XIV