Chapter 8, Problem 1ORSPA

Summary Introduction

To match: The surgical procedures in Column I with the indications for surgery in Column II.

Answer to Problem 1ORSPA

Correct answer:

COLUMN I	COLUMN II
1. Left oophorectomy	A. LLQ pain; ovarian mass on pelvic ultrasound
2. Vaginal hysterectomy with colporrhaphy	F. Uterine prolapse
3. TAH-BSO, pelvic and periaortic lymphadenectomy	C. Endometrial carcinoma
4. Exploratory laparotomy for uterine myomectomy	B. Fibroids
5. Conization of the cervix	E. Suspected cervical cancer
6. Lumpectomy with SLN biopsy.	D. Small invasive ductal carcinoma of the breast.

Explanation of Solution

1. 1. Left oophorectomy - A. LLQ pain; ovarian mass on pelvic ultrasound.

The prefix oopho– refers to the ovaries. The suffix –ectomy refers to excision or cutting. The left ovary is present on the left lower quadrant (LLQ) of the abdomen. The surgical procedure is done when an ovarian mass was detected in the left ovary during pelvic ultrasound. The patient would have experienced pain in the LLQ of the abdomen.

1. 2. Vaginal hysterectomy with colporrhaphy I - F. Uterine prolapse.

The prefix hyster– refers to the uterus. The suffix –ectomy refers to excision or cutting. The surgical procedure where the uterus is excised through the vaginal opening is vaginal hysterectomy. During the procedure, the vaginal wall will tear and therefore, colporrhaphy is also performed. The surgery is done typically for uterine prolapsed where the muscles around the uterus no longer support it and therefore, the uterus slips down from its position in the pelvic cavity and protrudes through the vagina.

1. 3. TAH-BSO, pelvic and periaortic lymphadenectomy - C. Endometrial carcinoma.

The prefix hyster– refers to the uterus. The prefix salpingo- refers to oviducts and fallopian tubes. The prefix oophor- refers to ovaries. The suffix –ectomy refers to removal. Thus removal of a pair of ovaries and a pair of fallopian tubes is called as bilateral salpingo-oophorectomy.  Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) is a surgical procedure where the uterus and both the ovaries are excised. The lymph nodes near these organs are also excised. This surgery is typically done when the female is affected with endometrial carcinoma.

1. 4. Exploratory laparotomy for uterine myomectomy- B. Fibroids

Uterine myomectomy is the surgical procedure to remove the fibroids of the uterus. In exploratory laparotomy the abdomen is surgically opened in order to examine and investigate the internal organs of the abdomen for injury and disease. Exploratory laparotomy for uterine fibroids is typically done to inspect the extent of the condition of the uterine fibroids and remove if it is necessary.

1. 5. Conization of the cervix - E. Suspected cervical cancer

Cervical conization is done as part of diagnostic procedure to detect cervical dysplasia or to check the extent of cervical dysplasia (cervical cancer). Usually tissue from the mucous membrane is excised as part of the procedure.

1. 6. Lumpectomy with SLN biopsy - D. Small invasive ductal carcinoma of the breast.

Lumpectomy is partial mastectomy where breast conserving surgery is performed. It is done to remove the cancerous tissue of the milk ducts in the breast. A small incision is done and only the cancerous tissue is removed.