Special Surgical Procedures II
LESSON 2: Procedures in Gynecological and Obstetrical Surgery
Section Ii:
2-12
Section II. VAGINAL SURGERY
2-12. PATIENT PREPARATION
a. Surgery on the structures of the reproductive system in the female may be done either for diagnostic purposes or as a form of therapy in the treatment of a pelvic condition such as uterine bleeding or suspected cancer. Surgery is also done to remove tumors or repair structures.
b. For vaginal and perineal surgery, the lithotomy position is generally used. For abdominal surgery, the patient is placed in a modified or extreme Trendelenburg position. Care should be taken to prevent the patient from nerve injury and provide for circulatory and respiratory functioning.
c. Skin preparation and draping procedures are routine. A sterile lithotomy pack is needed for vaginal surgery, a laparotomy pack for abdominal surgery.
d. Because pelvic and vaginal procedures involve manipulation of the ureters, bladder, and urethra, indwelling urinary drainage systems are frequently established during surgery. Either the urethral Foley catheter or the suprapubic Silastic cannula directly into the bladder may be used, depending on the surgeon's preference and the type of surgery.
