EVALUATION OF PATIENTS FOR MICROSURGERY
| Autor: | Carl J. Levinson, John L. Marlow |
|---|---|
| Rok vydání: | 1980 |
| Předmět: |
Adult
Risk Microsurgery medicine.medical_specialty medicine.medical_treatment Physical examination Pregnancy medicine Operative report Humans Medical history Hysterosalpingography Laparoscopy Physical Examination medicine.diagnostic_test business.industry Obstetrics and Gynecology Endoscopy Surgery Female Sterilization Reversal business Infertility Female |
| Zdroj: | Clinical Obstetrics and Gynecology. 23:1195-1200 |
| ISSN: | 0009-9201 |
| DOI: | 10.1097/00003081-198012000-00024 |
| Popis: | Prior to undergoing conservative pelvic surgery for improvement of fertility, there must be meticulous preoperative evaluation. This evaluation involves a history, all previous records and operative reports, psychologic evaluation, physical examination, hysterosalpingogram, laparoscopy, and tests for male factor and ovulation. In history taking, the physician is most interested in past evidence of infection. The emotional status of the patient must be considered, especially for those individuals who are seeking sterilization reversal. Often, with a history of previous pelvic surgery the rate of success is lowered. Physical examination is usually not useful in predicting final outcome of microsurgery; however, it does determine the patient's general preoperative status. Hysterosalpingography and laparoscopy are complementary procedures which are the cornerstone of the preoperative evaluation. The 1st gives evidence of the status of the uterus and the tube proximal to the block, if 1 exists. If the block is in the isthmic portion, the hysterosalpingogram will indicate how much of the tube is patent next to the corpus. Preoperative laparoscopy is necessary for proper and complete evaluation of pelvic status; it allows the operator to visualize the distal segment of the tube. Laparoscopy indicates the extent of pelvic adhesion, ovary and tube involvement, mobility of the tube, extent of fimbrial involvement, and presence of disease. When all factors are taken are into consideration, the surgeon must determine whether the benefits of surgery will outweigh the risks. Patient age, emotional needs, other parameters of fertility, status of tubes and ovaries, etc. must all be taken into consideration. |
| Databáze: | OpenAIRE |
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