Special Surgical Procedures II
LESSON 2: Procedures in Gynecological and Obstetrical Surgery
2-41
2-41. SALPINGO-OOPHORECTOMY
a. General. This operation is the removal of a tube and all or part of the associated ovary. It may be done in some young women who are anxious to have children after all other methods of treatment have failed to cure chronic salpingo-oophoritis, in patients with ectopic tubal gestation, or in those with tuberculosis of the adnexa or large adnexal cysts. If both tubes and ovaries are diseased, they are removed with total hysterectomy.
b. Operative Procedure.
(1) The abdominal wall and peritoneal cavity are opened, as for laparotomy.
(2) The affected tube is grasped with Allis or Babcock forceps. The infundibulo-pelvic ligament is clamped with Mayo hemostats, cut, and ligated with chromic gut number 0 or number 2-0, swaged to a 1/2- circle, taper-point needle, or number 2-0 silk on a French-eye needle.
(3) The mesosalpinx is grasped with Kelly hemostats and divided with the suspensory ligament of the ovary.
(4) The cornual attachment of the tube is excised with a knife or curved scissors. Bleeding vessels are controlled with suture ligatures.
(5) The edges of the broad ligament are peritonealized from the uterine horn to the infundibulopelvic ligament, as for hysterectomy.
(6) The wound is closed as for laparotomy; dressings are applied and held in place with adhesive or plastic tape.
