Cervical amputation

Amputation of the cervix can be performed by various methods. This is due to the degree of its defeat and hypertrophy.

There are the following methods of conducting the operation:

- High amputation of the cervix;

- wedge-shaped removal of the vaginal part;

- conical removal;

- diathermoconization.

This surgical intervention is prescribed with a pronounced deformation as a result of multiple discontinuities, with chronic endocervicitis with connective tissue degeneration, hypertrophy or the presence of recurrent polyps. In addition, amputation of the cervix is indicated for leukoplakia, follicular hypertrophy, long-term non-healing or recurrent erosion, and erythroplasty.

The method of high removal is used for adenoma, deep ruptures in combination with ectropion (eversion of the mucosa). In addition, this technique is used in the case of pronounced elongation of the cervix, which extends beyond the limits of the sexual slit.

Cone amputation is suitable for relapsing erosions, chronic endocervicitis, accompanied by relapsing polyps.

The wedge amputation of the cervix is prescribed for moderate degree of follicular hypertrophy, as well as for other pathologies that do not require the use of high amputation.

In case of cancer diagnosis, a method of diathermoconization using an electron-knife or a method of knife-like conical removal can be used. In this case, the first method is more expedient.

Supravaginal amputation of the uterus is a surgical removal of the body body in the area of the internal pharynx in the region of the supravaginal cervical region. Thus, after intervention, only the cervix remains.

In some cases, the removal of the body of the uterus is slightly higher than the internal pharynx. This allows you to save a small area of the endometrium (mucosa). In the presence of functioning ovaries in a reduced (reduced) form, he (endometrium) undergoes the same stages of changes as during the cycle of menstruation. As a rule, there are no monthly intervals after supravaginal removal.

During such intervention, the vagina can not be opened. In the area of the internal throat, the contents in the cervical canal, as a rule, are sterile. At the same time, the peri-vaginal removal of the uterus, carried out by the abdominal wall method, is an intervention taking place in the conditions of an aseptic surgical field. The exception is when the operation is performed for inflammation in the appendages of the organ, perforation or spontaneous rupture during pregnancy.

Amputation of the uterus. Effects

To intraoperative complications include damage to the ureters, the bladder.

More dangerous consequences - the formation of hematomas, bleeding. Hemorrhages in the postoperative period are diagnosed and eliminated quite difficult. This is due to the fact that they occur in a closed space (parameter), and then into the abdominal cavity (or directly into it immediately). In this regard, during the peritonization phase of the stump of all vessels and ligaments, a second examination and, if necessary, additional dressing (especially in the presence of massive ligatures, dilated varicose vessels) are performed. If necessary, in the control of hemostasis, there is a mandatory drainage of the peritoneum or an increase in the volume of surgical intervention before extirpation.

Postoperative consequences include the formation of hematomas, bleeding. In such cases, after intervention, relaparotomy is indicated. In the case of late diagnosis, suppuration hematomas appointed relaparotomy, draining and sanation of the small pelvis, extirpation of the stump.