lunes, 1 de noviembre de 2010

COLPOCLEISIS LEFORT

Surgical Technique of Colpocleisis

Vaginal Prolapse
Vaginal Vault Prolapse

Complete vaginal vault prolapse (direct view of the vaginal opening) – The vagina has fallen completely inside out.



Incision and Removal of Skin
Incision and removal of skin – skin is removed from the prolapse of expose the anterior fascia(pubocervical fascia) and posterior fascia) rectovaginal fascia. The fascia is identified because it is the supportive layer.
Suturing

Suturing – the skin has been removed and the underlying strong tissue (pubocervical and rectovaginal fascia) are identified. The tissue is sewn together in a circular fashion (like the drawstrings on a purse).


Sewing the skin
Sewing the skin –after multiple circular sutures are placed and the prolapse is progressively reduced, the prolapse is completely reduced back into the patients vagina and pelvis. The kin edges from the original incision are then closed using suture.
Reducing the prolapse

Reducing the prolapse – the most protruding portion of the vagina is inverted (pushed in upon itself) and the last suture placed is tied. The suture holds the rest of the vagina from coming back out or prolapsing.


Final Result - colpocleisis
The completed procedure usually leaves the patients with a very shortened vagina... thus making the patient incapable of engaging in sexual intercourse. Dr. Miklos recommends this operation to patients who are no longer sexually active nor have plans for future sexual intercourse.

A phase 3 trial of hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer.

Antecedentes: La cirugía citorreductora y la terapia sistémica son esenciales para el cáncer de ovario recientemente diagnosticado. Se reali...