D&C

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School

Holmes Colleges Melbourne *

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Course

801

Subject

Nursing

Date

Nov 24, 2024

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docx

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PREOPERATIVE DIAGNOSIS : Menometrorrhagia. POSTOPERATIVE DIAGNOSIS : Menometrorrhagia. OPERATIVE PROCEDURE : 1. Diagnostic hysteroscopy. 2. D&C. 3. NovaSure ablation. SURGEON : Chris Grady, MD ANESTHESIA : General. IV FLUIDS : Per Anesthesia. DRAINS: In-and-out cath. ESTIMATED BLOOD LOSS : Minimal. COMPLICATIONS: None. SPECIMENS: Endometrium. INDICATIONS : The patient with a history of menometrorrhagia and irregular bleeding for which she wished definitive therapy. The risks, benefits, and alternatives of the above procedure were discussed with the patient. Written consent was obtained. She agreed to proceed. FINDINGS: Per hysteroscopy, normal-appearing cervix, endocervix, normal-appearing uterine cavity, no evidence of any polyps or submucous fibroids. DESCRIPTION OF PROCEDURE : Once consent was obtained, the patient was taken to the operating room and placed in supine position. Once general anesthesia was found to be adequate, the patient’s legs were placed in the Yellofin stirrups and she was prepped and draped in normal sterile fashion with in-and-out catheter had been performed. A weighted speculum was placed in the vagina. The cervix was grasped with a single-tooth tenaculum and the cervix was dilated using Pratt dilators. Uterus

sounded to approximately 10 cm but was found that the cervical length was 5 with uterine cavity length being 5 as well. Camera was placed into the uterine cavity. Pictures were taken. D&C was performed with the specimen handed off. The NovaSure was placed without difficulty in the uterine cavity. Uterine length was 5, uterine width was 4.6 with a calculated power of 127. The ablation time was 1 minute and 5 seconds. At the close of the procedure, all instruments were removed from the patient’s vagina. One final look with a hysteroscope was done for post- procedure pictures. At the close of the procedure, all instruments were removed again from the patient’s vagina. She was awakened, extubated, and taken to the recovery room in stable condition. Sponge, lap, and needle counts were correct x2.

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