Special Surgical Procedures II
LESSON 2: Procedures in Gynecological and Obstetrical Surgery
Section Ii:
2-22
2-22. REMOVAL OF PEDUNCULATED CERVICAL MYOMA
a. General. This operation involves the removal of a tumor by the snare method or by dissection from the cervical canal with a knife (or with cold-knife conization). Cervical polyps stem from the endocervical canal. They may vary in size and are soft, red, and friable. Bleeding may result from the slightest trauma. Usually, the surgeon performs an endometrial and endocervical curettage and a cytological smear is taken.
b. Operative Procedure.
(1) The anterior lip of the cervix is grasped with a Jacobs vulsellum forceps. The canal is sounded and dilated to either visualize or palpate the base of the pedicle.
(2) If the pedicle of the tumor is thin, a tonsil snare may be placed over the body of the tumor, permitting the snare to crush the base of the tumor and to control bleeding. If the tumor is large, its base is dissected out with a knife. Bleeding is controlled by the use of warm, moistened gauze sponges on holders.
(3) Retractors are withdrawn; vaginal packing may be introduced into the cervical canal. The tenaculum is removed from the cervix, and a dressing applied and held in place with a binder.
