Chapter
1.1 Pre- and Postoperative Treatment
1.1.1 Preoperative Treatment
Ambulant/In-patient Treatment
Laboratory and Imaging Tests
1.1.2 Postoperative Treatment
Closed Drain Systems without Suction
Closed Drain Systems with Suction
Open Drains without Suction
1.4.1 Abdominal Procedures
1.4.3 Laparoscopic Procedures
II. Complications and Their Management
2.1 Bleeding Complications
2.1.1 Intraoperative Bleeding—Abdominal Procedures
2.1.2 Intraoperative Bleeding—Vaginal Procedures
2.1.3 Intraoperative Bleeding—Laparoscopic Procedures
2.1.4 Postoperative Bleeding
2.2 Inflammatory Complications
2.3 Injury to the Urinary Organs
2.4 Gastrointestinal Tract Injury
2.5 Wound Dehiscence and Hernia
3.1.2 Opening the Abdomen
Median Vertical Laparotomy
Pfannenstiel Transverse Fascial Incision
Cohen Modification of the Transverse Fascial Incision (Misgav Ladach Method)
Cherney Suprapubic Transverse Fascial Incision— Transection of the Rectus Attachment
Suprapubic Maylard Incision
Separate Opening of Abdominal Layers with Longitudinal Fascial Incision
Infraumbilical Minilaparotomy
Technique in Cases of Morbid Obesity
Correction of Defects in the Abdominal Wall
Relief Sutures in Dehiscence of Abdominal Sutures
3.2.2 Approach to the Abdominal Cavity
3.2.3 Insertion in Special Operations
3.2.5 Closure of Trocar Insertion Points
3.2.6 Laparoscopic Retrieval Techniques
4.1 Preliminary Remarks about the Region
4.1.1 Topography of the Retroperitoneum
4.1.1.2 Retroperitoneum_Nerves
4.1.1.3 Retroperitoneal Space_Vessels
4.1.1.4 Retroperitoneal Space_Course of the Ureter
4.1.1.5 Retroperitoneal Space_Lymph Nodes
4.1.2 Functional Pathology
4.1.3 Morphologic Pathology—Histology
4.1.4 Terminology and Diagnosis
4.1.4.1 Stages and Classification of Endometriosis
4.1.4.2 Stages of Fallopian Tube Carcinoma
4.1.4.3 Stages of Ovarian Cancer
4.2 Concepts for Surgical Treatment—Procedure Navigator
4.3.1.1 Ovarian Wedge Resection, Ovarian Cystectomy, Removal of an Intraligamentous Cyst, Simple Oophorectomy
4.3.1.2 Open Salpingo-Oophorectomy
4.3.1.3 Open Salpingotomy/Salpingectomy in Ectopic Pregnancy
4.3.1.4 Open Sterilization Operations
4.3.1.5 Open Infertility Surgery
4.3.1.6 Abdominal Surgery of Endometriosis
4.3.1.7 Surgery of Malignant Adnexal Tumors/Debulking Operations
4.3.2.1 Vaginal Salpingo-Oophorectomy
4.3.3.1 Laparoscopy—Diagnostic and Minor Operative Procedures
4.3.3.2 Laparoscopic Adhesiolysis
4.3.3.3 Laparoscopy of Pelvic Inflammatory Disease
4.3.3.4 Laparoscopic Fertility Surgery
4.3.3.5 Laparoscopic Sterilization
4.3.3.6 Laparoscopic Ovarian Cystectomy, Hydatid Removal
4.3.3.7 Laparoscopic Ovariopexy
4.3.3.8 Laparoscopic Operation for Ovarian Torsion
4.3.3.9 Laparoscopic Salpingo-Oophorectomy
4.3.3.10 Laparoscopic Removal of Cystic and Solid Adnexal Tumors
4.3.3.11 Laparoscopic Removal of an Ectopic Pregnancy
4.3.3.12 Laparoscopic Treatment of Endometriosis
5.1 Preliminary Remarks about the Region
5.1.1 Topography of Pelvic Spaces
5.1.1.1 Classification of the Spaces
5.1.1.2 Paravesical Space
5.1.1.5 Rectovaginal Septum
5.1.1.8 Pelvic Retroperitoneum—Nervous Structures
5.1.2 Functional Pathology—Developmental Disorders
5.1.3 Morphologic Pathology—Histology
5.1.4 Terminology and Diagnosis
5.1.4.1 Stages of Cervical and Endometrial Carcinoma
5.1.4.2 Classification of Gynecologic Malformations
5.2 Concepts for Surgical Treatment—Procedure Navigator
5.3.1.1 Abdominal Myomectomy
5.3.1.2 Abdominal Hysterectomy
5.3.1.3 Abdominal Supracervical Hysterectomy
5.3.1.4 Abdominal Radical Hysterectomy
5.3.1.5 Abdominal Lymphadenectomy for a Malignancy of the Internal Genitalia: Para-aortic Lymphadenectomy
5.3.1.7 Postpartum Hysterectomy
5.3.1.8 Operations for Uterine Malformations
5.3.2.1 Minor and Diagnostic Procedures
5.3.2.2 Curettage and Polypectomy
5.3.2.4 Laser Therapy of the Cervix, Cryotherapy
5.3.2.6 Extirpation of the Cervical Stump
5.3.2.7 Vaginal Hysterectomy
5.3.2.8 Vaginal Hysterectomy for Uterine/Vaginal Prolapse
5.3.2.9 Radical Vaginal Hysterectomy
5.3.2.10 Suction Curettage in Abnormal Early Pregnancy
5.3.2.11 Operations for Cervical Insufficiency—Cerclage
5.3.3.1 Diagnostic Hysteroscopy, Hysteroscopic Biopsy, Hysteroscopic Removal of a Lost IUP/IUD
5.3.3.2 Hysteroscopic Septum Dissection, Hysteroscopic Polypectomy, Hysteroscopic Myomectomy
5.3.3.3 Hysteroscopic Endometrium Ablation, Hysteroscopic Synechiolysis
5.3.3.4 Laparoscopic Myomectomy
5.3.3.5 Laparoscopic Hysterectomy
5.3.3.6 Laparoscopic Pelvic Lymphadenectomy
5.3.3.7 Laparoscopic Para-aortic Lymphadenectomy
5.3.3.8 Laparoscopic Hysterectomy for Uterine Malignancy
6.1 Preliminary Remarks on the Region
6.1.1 Topography of the External Genitalia
6.1.1.2 Subcutaneous Parts of the Vulva: Superficial Perineal Space
6.1.1.3 Muscle and Aponeurotic Base of the Vulva
6.1.1.4 Blood Supply and Innervation of the Vulva and Vagina
6.1.1.5 Deep Muscle and Fascial Layer of the Vulvar Region
6.1.2 Functional Pathology—Developmental Disorders
6.1.3 Morphological Pathology—Histology
6.1.4 Terminology and Diagnosis
6.1.4.1 Staging and Treatment of Vulvar Cancer
6.1.4.2 Staging and Treatment of Vaginal Cancer
6.2 Concepts for Surgical Treatment—Procedure Navigator
6.3.1.1 Inguinofemoral Lymphadenectomy
6.3.1.2 Surgical Treatment of Vaginal Carcinoma
6.3.2.1 Diagnostic Procedures on the Vulva and Vagina
6.3.2.2 Laser Surgery on the Vulva and Vagina
6.3.2.3 Surgery of Cysts of the Vulva and Vagina
6.3.2.4 Carcinoma in Situ in the Vaginal Stump
6.3.2.5 Nonradical Vulvectomy Techniques
6.3.2.6 Extended Local Excision of Vulvar Carcinoma
6.3.2.7 Radical Total Vulvectomy
Reconstructive and Plastic Surgery
6.3.3.1 Suture of Episiotomy and First- and Second-Degree Perineal Tears
6.3.3.2 Suture of Third- and Fourth-Degree Perineal Tears
6.3.3.3 Correction of Old Third- and Fourth-Degree Perineal Tears
6.3.3.4 Procedures on the Hymen and Introitus
6.3.3.5 Surgery of Vaginal Septa
6.3.3.6 Surgery on the Labia and Clitoris
6.3.3.7 Coverage of Defects in the Vulva and Vagina I—Transposition Flap and Bulbocavernosus Repair
6.3.3.8 Coverage of Defects in the Vulva and Vagina II—Myocutaneous Flaps
7.1 Preliminary Remarks about the Region
7.1.1 Topography of the Access Pathways
7.1.1.1 Vaginal Approach_Muscle Layers
7.1.1.2 Vaginal Approach_Connective Tissue Structures
7.1.1.3 Vaginal Approach_Vessels, Nerves, Ureter
7.1.1.4 Abdominal Approach _Muscle Layers
7.1.1.5 Abdominal Approach _Connective Tissue Structures
7.1.1.6 Abdominal Approach _Vessels, Nerves, Ureter
7.1.2 Positional Change of Urinary Bladder, Internal Genitalia, Rectum
7.1.2.2 Surgically Important Situations
7.1.3 Continence and Incontinence
7.1.3.2 Surgically Important Situations
7.2 Concepts for Surgical Treatment—Procedure Navigator
7.3.1.1 Abdominal Retropubic Colposuspension Operation
7.3.1.2 Abdominal Paravaginal Colpopexy
7.3.1.3 Abdominal Colposacropexy (Colpocervicopexy)
7.3.1.4 Abdominal Enterocele Operations (Halban, Moschkowitz)
7.3.1.5 Abdominal Correction of a Vesicovaginal Fistula
7.3.2.1 Anterior Colporrhaphy
7.3.2.2 Vaginal Paravaginal Colpopexy
7.3.2.3 Posterior Colporrhaphy
7.3.2.4 Vaginal Sacrospinal Fixation
7.3.2.5 Vaginal Uterosacral Fixation
7.3.2.6 Vaginal Enterocele Repair
7.3.2.8 Suburethral Sling Operations
7.3.2.9 Suburethral Heterologous Tension-free Sling Operations (TVT, TVT-O)
7.3.2.10 Pelvic Floor Reconstruction with Mesh Implants
7.3.2.11 Peri- and Intraurethral Collagen Injection
7.3.2.12 Vaginal Correction of a Vesicovaginal Fistula
7.3.2.13 Vaginal Correction of a Rectovaginal Fistula
7.3.3.1 Laparoscopic Retropubic Colposuspension
7.3.2.2 Laparoscopic Paravaginal Colpopexy
7.3.3.3 Laparoscopic Colposacropexy (Colpocervicopexy)
VIII. Gynecologic Oncology, Urogynecology, Proctogynecology: New Surgical Techniques
8.1.1 Development of Evisceration Surgery
8.1.2 Indications and Contraindications
8.1.3 Problems of Operation Technique
8.1.4 Errors and Failures
8.1.5 Operation Procedures
Starting the Operation and Preparation for Exenteration
Perineal Phase/Infralevator Exenteration
Reconstructive Aspects of Exenteration
Restoration of Bowel Continuity
8.1.6 Systematic Exenteration
8.1.8 Concurrent and Postoperative Treatment
8.1.9 Limits of the Method
8.2 Gynecology—Urology—Proctology
8.2.1 Gynecologic Urology
Loss of the Urethra (Neourethra)
Symmonds Urethral Reconstruction
Symmonds Myocutaneous Labial Flap
8.2.2 Special Urologic Procedures
Modified Boari Flap Operation
8.2.3 Gynecologic Proctology
Proctological Examination Techniques
8.3.5 Argon Plasma Coagulator
8.3.7 UltraCision/Harmonic Scalpel
8.3.9 Robotic Surgery in Gynecology
Indications, Contraindications, and Patient Selection
Preoperative Preparation and Patient Positioning
Trocar Placement and Docking/Undocking of the Robotic System
List of Illustrations from Other Works
Atlas of Gynecologic Surgery
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