Topics of the lesson: Surgical accesses to lesser pelvis organs. Capillary puncture of the bladder. Bladder high section surgery. Cystostomy. Surgical treatment of the hydrocele testis. Surgery for ectopic pregnancy. Rectum surgery. Blockade by Shkolnikov-Selivanov.
22.1. Name the options of access to structures and organs of the lesser pelvis. Draw the access to pelvic parts of ureter.
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Fig. 22.1. Surgical accesses to small pelvis organs
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Fig. 22.2. Needle direction during pelvic blockade 22.2. Write indications and technique for blockade by Shkolnikov-Selivanov.
THE BLOCKADE OF SHKOLNIKOV-SELIVANOV |
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THE BLOCKADE OF SHKOLNIKOV-SELIVANOV |
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Fig. 22.3. Stages of surgical treatment of hydrocele
22.3. Sign the stages of surgical treatment of hydrocele testis, presented in the Fig. 22.3.
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22.4. Explain the situation happened in this clinical case.
A patient with acute urinary retention (due to adenoma of prostate gland) was delivered to the hospital. The urinary bladder is palpated up to the level of the navel.
Explain the reason of urine retention.
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Why during overflow the urinary bladder can grow only up to the navel, but not higher?_
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What urgent operation is indicated to the patient?_
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Describe that technique_
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Fig. 22.4. Topography of the male pelvis
22.5. Explain the situation happened in this clinical case.
High section of the urinary bladder (epicystostomy) is being performed to the patient. Describe the surgical access. Can this access be named «lower midline laparotomy»? Why?_
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Describe the stages of epicystostomy (high section of the urinary bladder) using Fig. 22.5.
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Fig. 22.5. Stages of epicystostomy (high section of the urinary bladder)
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What stages of operation are indicated by numbers 3 and 4? 3. __