Question

CASE STUDY 

A 59-year-old patient has been diagnosed with endometrial cancer and admitted for a radical hysterectomy with bilateral lymphadenectomy. The procedure will be performed through a midline incision and is expected to take 3 hours. 

1. What anatomical structures will be sent for pathology? 

2. What specific patient care is required between the time the patient is transported to the OR and the patient is anesthetized? Guacolonical and o

3. Which abdominal self-retaining retractors might be ing retractors might be used in this procedure? mat size and type of suture might be used on the uterine ligaments? 

5. How will the lymph nodes be managed on the back table? How will they be identified and labeled? 

6. Will the retroperitoneum be entered in this procedure? 

7. What instrument sets will be required for the procedure? al prep 

8. Will vaginal prep be necessary for the procedure? Provide the rationale in your answer.

Answer 1

1.The anatomical structure which will be removed in radical hysterectomy is the uterus, upper part of vaginal opening,ovaries ,fallopian tubes,cervix. It is the main part of reproductive system.A sample tissue will be taken from these parts for pathological investigations.

2.The specific care required between transferring to OR and until anthetising are

• Patient preparation (attaching all the required monitors to the patient to monitor blood pressure, heart rate ,pulse ,respiration oxygen saturation)
• Initiation of peripheral line to administer medication , IVF or blood products due intraoperative period
• Skin preparation at the back ,abdomen and at perineal area
• Foley's catheterization

3.It is a operation which done internal or deep into abdomen so Balfour Abdominal retractor can be used throughout the surgery .

4.Absorbable suture material has to be used in the suturing of uterine ligaments.Catgut,silk, Vicryl are absorbable suture material which is absorbed in about 56 to 70 days after the day of surgery meanwhile the sound heals completely. The size 2-0 are commonly used because it is very thin in diameter compared to other sizes .