Total Abdominal Hysterectomy Bilateral Salpingo-oophorectomy - Research Paper Example

? Total Abdominal Hysterectomy Bilateral Salpingo-oophorectomy Total Abdominal Hysterectomy Bilateral Salpingo-oophorectomy Surgery has been used to cure some diseases by either repairing certain body parts or organs or by removing body tissue to prevent the spread of the disease. According to Hooper (1994), it is the solution to injuries by doing operations such as cutting, sewing, adding or removing something to the affected body part. Surgery can also be done to cease the pain (National Institutes of Health, n.d.). Only licensed and skilled specialists like a physician or surgeon are allowed to do the procedure. Surgeons then specialize at certain human body parts like bones, brain, or heart. The surgery can be done as either minor operation or major procedure (Heisler, 2009). The practice shows how important it is in the field of medicine as drugs alone are not sufficient to cure the diseases of people. For diseases like cancer, once the cancer cells become tumors, they must be removed from the infection site. When endometrial cancer or any cancer that infects the reproductive system of a woman, patients are advised by physicians to have surgery. The operation is called hysterectomy. The process allows the surgeon to remove the uterus, and according to the records of Centers for Disease Control and Prevention, 600,000 operations of that kind is being conducted every year (Jick, 2004). The statistics obtained by CDCP shows how important that surgery to save the lives of women. Once the cancerous ovary and uterus are not removed from a cancer patient, it may spread to other parts until the general well-being of the patient gives up and her immune response is so weak that opportunistic infections may cause huge damage to her body that may lead to death. The concern of hysterectomy is the female reproductive system including parts such as fallopian tubes, uterus, blood vessels, ovaries, and ligaments. The uterus then has the lining called endometrium and below the uterus, vagina and cervix can be seen (Jick, 2004, p. 322). There are various kinds of hysterectomy. When the surgical removal of uterus allows the cervix to maintain its original place, the operation is called partial hysterectomy. As the years allow development in the medical field, hysterectomy can be performed now using laparascope to retain the cervix at its original position. In some cases, the cervix is also removed together with the uterus and the procedure is called total hysterectomy. When the surgery is done in the abdomen, it is known as abdominal hysterectomy. If the operation is conducted through a hole in the vagina, the method is called blind hysterectomy as the doctor cannot locate the organs at certain times during the procedure. The more popular vaginal hysterectomy than the blind hysterectomy is the procedure with the aid of laparascope that makes it laparoscopy assisted vaginal hysterectomy. If ovaries are then removed together with the fallopian tubes and uterus, it is called hysterectomy with either unilateral or bilateral salpingo-oophorectomy (Horn and Miller, 2008, p. 95). The different kinds of hysterectomy presented can all be done in one surgery and the technique is now called Total Abdominal Hysterectomy Bilateral Salpingo-oophorectomy (Conner and Dawson, 2009, p. 590). The paper focuses on the last type and most complete hysterectomy. Surgery like hysterectomy is very much needed to patients with endometrial cancer. According to statistics, about 70-75% of patients undergo that procedure with stage one cancer while 10-15 percent receive that surgery are patients who are at stage two or even stage three. The operation allows the physician to learn about the progression of the disease, healing benefits, stop vaginal bleeding, and cure the disease that keeps coming back. Usually the total abdominal hysterectomy bilateral salpingo-oophorectomy is done on patients with stage one endometrial cancer. It has been a standard especially for cancer centered on the uterine corpus (Ajithkumar et.al., 2011). The surgery is a bit complicated when it comes to curing the endometrial cancer at uterine corpus. The total abdominal hysterectomy bilateral salpingo-oophorectomy is complicated and should be done with great care. Surgeons perform it in the following manner: lithotomy position; empty bladder with catheter, skin crease transverse incision, raise flap cephalad and make vertical midline incision through fascia, thorough abdominal exploration, grasp uterine fundus with two Kelly clamps and elevate, divide round ligaments with clamps and ties, if ovary is to be spared, divide uterine tube and ovarian ligament, if ovary is to be taken, incise broad ligament lateral to tube and ovary, identify and protect ureter, secure uterine vessels, incise peritoneum overlying bladder and created bladder flap, continue dissection to uterine cervix and divide, vaginal cuff may be closed with running lock stitch or over sewn and left open, close abdomen in usual fashion without drains, (Conner and Dawson, 2009, p. 590). The procedure went a long list but does not ensure that it is 100% safe as some complications may arise. Since it is a major surgery, the existence of risks cannot be denied. Some of the risks are side effects of anesthesia, scar affecting bowel movement, blood clot in vessels, infection development, large amount of blood loss, internal organ damage, fistula development, and prolonged recovery time (Jick, 2004). Anesthesia usage can be risky as it can cause nausea, vomiting, cognitive dysfunction, respiratory depression and motor problems (Euliano, Gravenstein, and Gravenstein, 2011, p. 21). Scars can affect bowel movement as it may block the passage. Blood clot can block the blood flow and the lack of oxygen may lead to death of tissues (Aschenbrenner and Venable, 2009, p. 598). Fistula development is the formation of a new connection from the outside hole like at rectum or external genitalia going to the inside. Other risks may be seen long term such as higher probability of getting a heart disease, Parkinson’s disease and dementia. Previous studied do not have enough findings about the certain substance that may have been released by ovaries to protect the woman from the said diseases (Horn and Miller, 2008, p. 97). After all, ovaries have some ability to release small amounts of estrogen even after menopause, so it may explain the increased risk of disease when the organs are removed. Studies also have seen some improvements in sexual satisfaction and performance after ovary removal according to the patients (Horn and Miller, 2008, p. 97). Some other particular damages or risks are injury to ureter and injury to bladder as the operation opens up on the lower part of the abdomen hitting the reproductive and excretory system (Conner and Dawson, 2009). For endometrial cancer patients, it is common to undergo hysterectomy first and then followed by chemical therapy and radiation therapy. For those with cancer possibility, they undergo dilation and curettage before hysterectomy. For those with cancer stage, they experience Total Abdominal Hysterectomy Bilateral Salpingo-oophorectomy (Rees, 1997, p. 490). References Ajithkunar, T., Barrett, A., Hatcher, H. and Cook, N. (2011). Oxford desk reference oncology. New York: Oxford University Press. Aschenbrenner, D. and Venable, S. (2009). Drug therapy in nursing. China: Walters Kluwer Health. Conner, C. and Dawson, D. (2009). Operative anatomy 3rd ed. Philadelphia: Lippincott Williams and Wilkins. Euliano, T., Gravenstein, J., and Gravenstein, N. (2011). Essential anesthesia. United Kingdom: Cambridge University Press. Heisler, J. (2009). Surgery defined - What does surgery mean? About. Retrieved from http://surgery.about.com/od/glossaryofsurgicalterms/g/Surgery.htm Hooper, T. (1994). Surgery. USA: Hodder Wayland. Horn, J. and Miller, R. (2008). The smart woman's guide to midlife & beyond: A no-nonsense approach to midlife and beyond. USA: New Harbringer Publications. Jick, B. (2004). Hysteroctomy. In S. Loue and M. Sajatovic (Eds.), Encyclopedia of women's health. New York: Kluwer Academic. National Institutes of Health. (n.d.). Surgery. Medline Plus. Retrieved from http://www.nlm.nih.gov/medlineplus/surgery.html. Rees, A. (1997). Consumer health USA. Arizona: Oryx Press. Read More