Colpotomy procedure in Iran

colpotomy in iran

Colpotomy procedure in Iran

What is Colpotomy?

A colpotomy, also known as a vaginotomy, is a procedure by which an incision is made in the vagina.

A colpotomy is performed either to visualize pelvic structures or to perform surgery on the fallopian tubes or ovaries.

Role of colpotomy in gynecologic surgery

Several gynecologic surgery protocols require a colpotomy as part of the overall surgical procedure. It is performed whenever the surgeon needs to access the vagina. Several of these surgeries include:

. Tubal sterilization. Sterilization is a procedure that can be performed using either abdominal or vaginal procedures. When a vaginal procedure is selected by the surgeon, he performs a colpotomy and may also insert a culdoscope to locate the tubes (culdoscopy), and close them off.

. Removal of myomas. Myomas are fibroid tumors of the muscle tissue of the uterus and they are sometimes removed vaginally by colpotomy.

. Removal of pelvic cysts and masses. In one treatment variant, patients may undergo a laparoscopy followed by a colpotomy for the vaginal extraction of the pelvic cyst or mass.

. Hysterectomy. One technique used to surgically remove the uterus combines three steps, an initial laparoscopic stage, followed by a vaginal stage, and a final laparoscopic stage. The colpotomy is performed during the second step to deliver the uterus into the vagina.

. Dysmenorrhea. Separation of the uterosacral ligaments via colpotomy is an approach that has been used for the relief of dysmenorrhea (painful menstruation).

. Complications in pregnancy and childbirth. Colpotomy may be used in the management of difficult pregnancies and childbirths.

iranian surgery

Description

The patient is placed in a supine position on the operating table with her legs in stirrups and the incision site is prepared. An antiseptic solution, such as chlorhexidine, is applied to the skin using highly disinfected forceps and gauze swabs. The patient is covered with surgical drapes with the window positioned directly over the incision site. Throughout the procedure, the vital signs of the patient are monitored (blood pressure, pulse, respiratory rate) as well as her level of consciousness and blood loss. Pain management depends on the surgery that requires the colpotomy, and may involve local, regional, or general anesthesia. The incision is only made as large as necessary for the requirements of the overall surgery.

For example, when a decision has been made to remove a myoma by colpotomy, the procedure may proceed as follows:

. A small myoma screw is inserted into the myoma and a grasper with locking mechanism is placed on the lower edge of the wound.

. The myoma is directed toward the cul-de-sac using the myoma screw.

. A colpotomy is performed.

. The myoma is grasped and removed vaginally. During this part of the procedure, the surgeon examines whether the myoma extends into the uterine cavity.

. If it does, the uterus is guided to the colpotomy site. T-clamps are placed on the edges of the wounds and the fundus of the uterus is delivered, via the colpotomy incision, into the vagina.

. The uterus is sutured in three layers (endometrial, myometrial and serosal).

. The repaired uterus is returned to the abdominal cavity.

. The colpotomy incision is sutured.

Who performs the procedure and where is it performed?

A colpotomy is performed by a gynecological surgeon either in an outpatient clinic or in a hospital setting, depending on the overall surgical procedure of which the colpotomy is a part.

Preparation

The procedure is explained to the patient within the broader context of the surgery that includes the colpotomy. Preoperative preparation includes whatever is required for the overall surgical procedure that will be performed.

Aftercare

Aftercare for colpotomy is associated with the overall surgery that required the colpotomy.

For example, if a colpotomy is performed for tubal ligation (female sterilization), the procedure takes only 15-30 minutes and women usually go home the same day. It may take a few days at home to recover. Sexual intercourse is usually postponed until the colpotomy incision is completely healed, and as advised by the doctor. The healing process usually requires several weeks and there are no visible scars. In the case of a colpotomy performed for myoma removal, aftercare is more elaborate with the patient’s vital signs monitored in the recovery room until she regains consciousness.

Risks

Complications such as bleeding, infection, or reaction to the anesthetic, may occur as with any type of gynecological surgery.

Normal results

Colpotomy results are considered normal when the incision performed allows the surgeon to meet the goal of the overall surgical protocol.

10 common question about Colpotomy procedure

1What is a Colpotomy ring used for?
RUMI uterine manipulator is used to manipulate the uterus during surgery, and the Koh colpotomy ring is used to provide an insulated backstop for the colpotomy incision.
2What is the procedure for laparoscopic hysterectomy?
A laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. A small incision is made in the belly button and a tiny camera is inserted. The surgeon watches the image from this camera on a TV screen and performs the operative procedure.
3What is Minilaparotomy?
Minilaparotomy, generally referred to as “minilap,” is an abdominal surgical approach to the fallopian tubes by means of an incision less than 5 cm in length.As a sterilization procedure for permanently occluding the fallopian tubes, minilaparotomy has been performed safely and frequently in a wide range of countries ...
4What does Colpocentesis mean?
Medical Definition of colpocentesis : surgical puncture of the vagina.
5What does Culdocentesis mean?
Culdocentesis is a procedure in which peritoneal fluid is obtained from the cul de sac of a female patient. It involves the introduction of a spinal needle through the vaginal wall into the peritoneal space of the pouch of Douglas.
6What fills the space after a hysterectomy?
After a hysterectomy, the other abdominal organs shift slightly to fill the space. ... Unless extensive surgery is performed, the vagina remains the same after a hysterectomy.
7How long do you have to be on bed rest after a hysterectomy?
Most women go home 2-3 days after this surgery, but complete recovery takes from six to eight weeks. During this time, you need to rest at home.
8How long is laparoscopic hysterectomy procedure?
What you should expect from this surgery. Robotic-Assisted Radical Total Laparoscopic Hysterectomy usually takes 1-3 hours under general anesthesia.
9Can tubes grow back after removal?
If your fallopian tube has grown back together after tubal ligation, it's possible you could have a full-term pregnancy. Some women also opt to have a tubal ligation reversal, where a doctor puts the fallopian tubes back together.
10What is the CPT code for Minilaparotomy?
Minilaparotomy code depends on incision.

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