Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation.
Local anesthesia
Myomatous uterus
Pelvic organ prolapse
Uterus morcellation
Vaginal hysterectomy
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
06
12
2020
accepted:
04
02
2021
pubmed:
12
3
2021
medline:
21
8
2021
entrez:
11
3
2021
Statut:
ppublish
Résumé
In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthesia and conscious sedation. The patient underwent VH and PFR by using an infiltration of a local anesthetic solution of lidocaine, ropivacaine and adrenaline in combination with intravenous (iv) conscious sedation. Debulking techniques, such as intramyometrial coring, uterine bisection, myomectomy and wedge resection, were used to facilitate VH. The final weight of the removed uterus was 870 g. This video demonstrates that performing a surgically challenging VH under local anesthesia is feasible. Vaginal uterine morcellation can be performed to debulk the enlarged uterus so that hysterectomy can be accomplished under local anesthesia. The use of local anesthesia may safely be offered as an alternative to patients undergoing a complex vaginal hysterectomy and reconstructive surgery.
Identifiants
pubmed: 33704537
doi: 10.1007/s00192-021-04721-1
pii: 10.1007/s00192-021-04721-1
doi:
Types de publication
Case Reports
Journal Article
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
2287-2289Informations de copyright
© 2021. The International Urogynecological Association.
Références
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