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PROCEDURE AT A GLANCE
PERIOP BRIEFING
Total abdominal hysterectomy
INDICATIONS FOR PROCEDURE
Total abdominal hysterectomy involves the removal of the uterus, including the cervix and corpus, through an abdominal incision. This procedure may be performed to treat symptomatic pelvic relaxation or prolapse, pain associated with pelvic congestion, pelvic inammatory disease, endometriosis, broids (myomas), bleeding with no apparent cause in postmenopausal women,
adenomyosis, dysfunctional uterine bleeding, or cancer or conditions with high risk for malignancy.1
PREPARING FOR THE PROCEDURE
To provide constant bladder drainage during the operation, an indwelling catheter is placed.1
To follow standard procedures for skin antisepsis, perioperative RNs shouldo rst perform an internal vaginal prep using a separate prep tray and ensuring contact of the prep solution with the cervix, and
o then perform an abdominal skin prep.1,2
It is important to perform the vaginal prep rst to avoid needing to prep the abdominal skin a second time if solution from the vaginal prep splashes onto the abdomen.2
PATIENT POSITIONING
After the vaginal and abdominal prep, patients remain in lithotomy position or are placed supine, based on surgeon preference. After the surgeon opens the peritoneal cavity, the patient may be placed in the Trendelenburg position to improve access to the pelvic organs.1
http://dx.doi.org/10.1016/S0001-2092(17)30120-5 P10 | Periop Briefing
PERIOP BRIEFING
HYSTERECTOMY
BASIC WORKFLOW FOR PROCEDURE
To perform a total abdominal hysterectomy, the surgeon will1. create a Pfannenstiel incision (for a simple hysterectomy in a non-obese woman),...