TLH + BSO

DIGNOSIS:- - 2.2 x 2.7 cm Post.wall Adenoma. - 4 x 4 cm Lt Ovarian 3.6 x 3.6 cm Chocolate cyst. - 7.5 x 7.5 cm Rt Ovarian Chocolate Cyst. - Endometriosis.
TREATMENT (PLAN OF SURGERY):-TLH + BSO
OPERATIVE NOTES:- -Operation done under general anaesthesia by dr amit and Done By Dr.Pravin Kanani. - Primary trocher 10mm, 3 secondary trocher 5mm insertion done. - Adhesiolysis of omentum/ intestine/sigmoid colom done with sharp dissection. - Severe Adhesion Seen Between B/O Ovary Adherent With Each Other, With Post Wall Of Uterus With Lateral Pelvic Wall & Rectum. - Diversification of bladder muscle during bladder dissection & bladder mucosa protude. - Muscle Opposition Done By Vicryl No.1. - Adhesiolysis Done. - Both cornual ligament coagulation done with ligasure and cutting done with covidion knife. - Bilateral salphingectomy + opharectomy done with covidion knife. - Broad ligament open and disection done to denading of uterus vessels. - Uterine ligation with vessel sciller and cutter done with covidion knife. - U/S ligament + ligament seperation done. - Haemostasis - All procedure done opposite site manner. - Valt open at U/S ligament. - Uterus deliverd from vagina route or morcellation done with morcellator. - Specimen send for HPE. - Valt closer done with vicryl no 1(2347). - Saline wash given/ all ligament seen from bleedy which was normal. - Gas remove from cavity and stitch at port done with stepler. - End of surgary her vital data was normal. - Patient send in POST OPERATIVE CARE UNIT.