Uterus, Tubes, and Ovaries

Abstract

The role of ligaments as support for the uterus, fallopian tubes, ovaries, and bladder is described. The ovary has the capacity to produce many benign and malignant tumors; maximal effort should be focused on the preservation of useful function when the presumed histology is benign.

Both the surgical technique of abdominal hysterectomy and the significance of the procedure to the patient are covered. Different incisions are preferred for cancer, tubo-ovarian abscess, limited-dimension benign disease, and large fibroids or extensive endometriosis. A step-by-step general technique of hysterectomy, suitable when there is no significant disruption of the normal anatomy, is proposed; modifications are needed according to disease processes encountered. A modification for bilateral salpingo-oophorectomy is provided. A new section on ovarian cystectomy discusses treatment of ruptured and unruptured cysts in premenopausal and postmenopausal patients.