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Pelvic Gynecology Intervention, Complications and Significance of Teamwork Collaboration with Abdominal Surgeon

Henri Kolani, Rustem Celami, Etmont Çeliku, Skënder Topi

Abstract


Extensive gynecologic surgery often entails meticulous dissection near the bladder, rectum, ureters, and great vessels of the pelvis. Complications of gynecologic surgery include hemorrhage, infection, thromboembolism, and visceral damage. The risk of complications depends upon the extent and approach to surgery and patient characteristics. Understandably, the more common complications from this surgery relate to injuries to these viscera and occur during extensive resections for the treatment of cancer or when anatomy is distorted due to infection or endometriosis. Injuries to the gastrointestinal components are common during open gynecological surgery. Any delay in diagnosing a bowel perforation can lead to serious fecal peritonitis and even death. If a patient is experiencing pain, tachycardia, and fever following surgery, bowel injury should be suspected, warranting immediate consultation with a general surgeon. Gynecologists routinely operate on patients with risk factors for bowel injury; obesity, endometriosis, multiple abdominal procedures, pelvic inflammatory disease, history of malignancy, and advanced age. A general surgeon is often called, however, for bowel repairs that can be performed by a gynecologist with sufficient training and experience. There are instances, however, in which a general surgical consultation may not be readily available, another reason to master repair of bowel injuries encountered during gynecologic surgery. In conclusion, sufficient training of principles of intestinal surgery, and close collaboration with general surgeons is very important for management of these complications and a successful outcome.

Keywords: Gastrointestinal, injury, gynecologist, training, surgeon, management.


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DOI: http://dx.doi.org/10.0001/(aj).v4i4.1224

DOI (PDF): http://dx.doi.org/10.0001/(aj).v4i4.1224.g1698

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