A practical guide to office gynecologic procedures by Paul D Blumenthal MD MPH, Jonathan S. Berek MD MMS

By Paul D Blumenthal MD MPH, Jonathan S. Berek MD MMS

Office established methods in surgical fields are quickly transforming into taking into consideration swifter analysis and therapy. This new book, A functional advisor to workplace Gynecologic Procedures provides the step by step advisor to office-based techniques physicians have to deal with girls within the ambulatory setting.

Covering the main customary place of work gynecologic tactics, this new publication covers symptoms, right positioning, anesthesia and gear wanted for over 35 office-based strategies. Chapters additionally current cautious tips on powerful sufferer management.

Perform gynecologic systems in an economical ambulatory surroundings, whereas bettering the result in your sufferers with this easy-to-use medical reference. 

•    Written via the school, fellows, and citizens of the Stanford division of Obstetrics and Gynecology
•    comprises foreword via prestigious Editor, Dr. Jonathan Berek
•    sensible, illustrated advisor presents the “need-to-know” info on acting universal place of work procedures
•   CPT codes are indexed to save lots of you time
•    Over 250 complete color-figures (illustrations, photographs) support establish and exhibit tips to practice techniques
•    handy better half site contains totally searchable textual content and pictures delivering you entry to the content material anytime

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Sample text

2. Gently separate the labia. An assistant may be helpful for retraction of the labia during the procedure, so that the mucosal incision site can be accessed. 3. Clean the labia and surrounding areas in the usual sterile fashion. 4. Infiltrat 2 to 3 mL of lidocaine 1% solution subcutaneously under the mucosa of the labium minus. Incision and Drainage with Word Catheter Placement 1. With the No. 5 to 1 cm long incision into the abscess or cyst on the mucosal surface of the labium minus. The incision should be within the hymenal ring if possible (Fig.

Use the green filte examination to accentuate any abnormal vasculature. 8. Dilute Lugol’s iodine solution may be used to aid in detection (Schiller’s test). 9. Obtain biopsies from any concerning areas, label and place biopsies in formalin (Figs. 3). a. Sensitivity can be improved by performing a biopsy in each quadrant, but unless a very small biopsy instrument is used, it can also increase bleeding and discomfort. 10. Perform Endocervical Curettage (ECC) for AGC, ASC-H, HSIL, adenocarcinoma in situ (AIS), and for unsatisfactory colposcopy (For women <25 years old, with “inadequate colposcopy” and for whom only low grade cytology or ASC-US was the indication for colposcopy, repeat tesing at 6-months is preferable to ECC).

Monsel’s solution or silver nitrate can be used for hemostasis. Sutures (000 gut on a small cutting needle) are rarely needed. CPT Codes 56820. Colposcopy of the vulva; 56821. Colposcopy of the vulva; with biopsy(s) Pearls • Application of vinegar, chlorhexidine, or alcohol solutions can cause a local burning sensation and patient should be informed about this. • A dilute epinephrine solution (1:100,000) added to the local anesthetic can reduce bleeding and reduce the amount of local necessary to get adequate anesthesia.

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