Task Analysis of Laparoscopic Procedures

Laparoscopic Radical Hysterectomy Task Analysis
Gynecology / Apr 3rd, 2018 12:00 pm     A+ | a-
Laparoscopic radical hysterectomy in Gynecologic cancer. task analysis 
 
Dr Maliheh Arab, MD
 
1- Select the patient : Early stage cervical cancer- endometrial cancer with cervical involvement. 
2- Put the patient in lithotomy position. 
3- Telescope port position: 4cm above umbilicus ( supra umblical).
4- Working port position : Two 5mm right: ipslateral, and two 5mm left: ipslateral.
5- Open Peritoneum between round lig and infundibulopelvic ligament (IP) and cut downward towards iliac vessels .
6- Use harmonic for cutting ( metal part is open and cut with upward hanging and cutting of Peritoneum) or monopolar.
7- Find int iliac vessel by opening the peritoneum lateral to ureter just in junction of ureter and iliac vessels. cut uterine artery in its origin.
8- Dissect pararectal space lateral: to ureter and IP ligament : 
  • Anterior: uterine artery and lateral parametrium 
  • Lateral: posterior division of hypogastric artery  
  • Posterior: lateral surface of the sacrum
  • Medial: rectum
9- Dissect paravesical passa by cutting peritoneum downwards:
  • Lateral: ext. iliac and obturator fossa
  • Posterior: uterine artery and lateral parametrium 
  • Anterior: obturator muscle
  • Medial: bladder and vagina
10- Cut the uterine vein below ureter tp prevent bleeding in parametrial resection.
11- Cut parametrium which is located in front of pararectal space, near pevic.
12- Medial to ureter and IP ligament, cut the peritoneum towards down and medial to posterior cul de sac.
13- Expose rectovaginal space by dissecting denonvilie ligament and going down between uterosacral ligaments into the space.
14- Cut uterosacral ligaments in half of its length.
15- Open vagina circular by removing at least 2 centimeters of vagina.
16- Cut infundibulopelvic or utero. Ovarian ligament ( this step is postponed for better traction).
17- Vaginal cuff is closed by 3 extra corporal knots.
18- Ovaries might remain in young women 
19- Ophoropexis is considered in young women for protection of ovarian function if irradiation is needed ( probably not very effective)
20- Do pelvic lymphadenectomy at first part or second part of the surgery.
5 COMMENTS
Dr. Appolina Tooppo
#1
May 23rd, 2020 1:06 pm
Thank you so much for the Article. It's really awesome Task Analysis of Laparoscopic Radical Hysterectomy , very informative and educative and lot's of information. Keep it up the good work!
Thanks for posting.
Dr. Monalisa Kurmi
#2
May 23rd, 2020 1:13 pm
Thanks for posting this Task Analysis of Laparoscopic Radical Hysterectomy !! Dr. Mishra is so helpful and he make it so much easier to understand than the textbook! Keep it up!!


Dr. Suryakumar Yadav
#3
May 23rd, 2020 1:24 pm
Thank yous so much sir! I'm a final year PG student. Your videos are the reason I am doing laparoscopic Hysterectomy surgery. I am reading your all task analysis for butter understanding. Thanks for posting great Task Analysis for Laparoscopic Radical Hysterectomy.
Dr. Sulaiman Habib
#4
May 23rd, 2020 1:39 pm
Amazing explanation of the step surgery's. all step are very clearly understand and very interesting. Thanks uploading the Task analysis of Laparoscopic Radical Hysterectomy. you are the Great Example for our Nation.
Dr. khairul Hassan Khan
#5
May 23rd, 2020 2:18 pm
Thank you, so much, for your time and consideration in forming this Task Analysis of Laparoscopic Radical Hysterectomy. Thank u for this amazing explanation keep going.
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