Contents

Section I: Surgical Anatomy of Female Genital Tract

1.Vulva: Anatomy, Blood Supply and Lymphatic Drainage3

Asha Sharma, Amita Suneja

2.Pelvic Diaphragm and Supports of Uterus9

Abha Sharma

3.Uterus and Cervix: Relations, Blood Supply and Lymphatic Drainage15

Neerja Goel, Ruchika Garg

4.Adnexa in Relation to Vaginal Surgery20

Namita Grover, Shalini Rajaram

5.Applied Anatomy of Ureter in Relation to Vaginal Surgery26

Shalini Rajaram, Sandhya Jain

Section II: Preoperative Care, Operation Theatre, Sutures and Instruments

6.Current Concepts in Preoperative Care37

Rashmi Malik

7.Thromboprophylaxis for Vaginal Surgery46

Neerja Goel, Gunjan Singh

8.Reducing Surgical Risk for HIV and Hepatitis B Infection53

Shalini Rajaram, Asha Sharma

9.Operating Tables, OT Lighting and Positions for Vaginal Surgery65

Medha Mohta, Tarun Bhagchandani

10.Electrosurgical Cautery Units75

Manpreet Singh, Namita Grover

11.Sutures and Suturing Techniques87

Nitin Agarwal, Anshul Grover, Neerja Goel

12.Instruments for Vaginal Surgery98

Shalini Rajaram, Harsha Sharma, Nitin Agarwal

Section III: Anesthesia, Blood Transfusion and Sterilization Techniques

13.Anesthetic Considerations for Vaginal Surgery113

Ashok Kumar Saxena, Raman Azad, Nitin Jain

14.Blood Transfusion: Guidelines, Recommendations and Complications122

Nitin Jain, Ashok Kumar Saxena

15.Sterilization and Disinfection of Surgical Instruments and Endoscopes129

AK Sethi, Deepti Agarwal

Section IV: Vulval Surgery

16.Vulval Disorders (Non-neoplastic and Premalignant), Biopsy Techniques and Wide Local Excision151

Sudha Prasad, Shakun Tyagi

17.Hymenectomy, Labial Fusion Release, Introital Widening, Schuchardts Incision160

Neerja Goel, Rajni Gill

18.Bartholins Gland Surgery: Incision and Drainage, Marsupialization and Excision167

Rachna Agarwal, Gayathri R

19.Simple Vulvectomy for Intraepithelial Neoplasia177

Amita Suneja, Richa Agarwal

20.Radical Vulvectomy with Groin Dissection184

K Chitrathara, Rema P

21.Vestibulectomy for Vulvodynia195

Rachna Agarwal, Pushpanjali Rai

Section V: Vaginal Surgery for Prolapse and Reconstructive Vaginal Surgery

22.Current Concepts of Pelvic Organ Prolapse: Evaluation and Choice of Procedure205

KC Singh, SD Barman

23.Surgical Correction of Anterior Compartment Defects209

Abha Sharma

24.Surgical Correction of Posterior Compartment Defects217

Abha Sharma

25.Manchester Repair224

Kiran Guleria

26.Vaginal Hysterectomy and Enterocele Repair232

AG Radhika

27.Sacrospinous Colpopexy240

KC Singh, SD Barman

28.Posthysterectomy Vault Prolapse246

Sumita Mehta

29.Complete Perineal Tear258

Harsha Khullar, SK Bhandari, Kanika Jain, Geeta Mehdiratta

30.Radical Vaginal Hysterectomy266

Partha Basu

31.Vaginectomy277

K Chitrathara, Namrata Kachhara

32.Colpocleisis286

Neerja Goel, Seema Ummat

33.Culdocentesis and Colpotomy293

Shalini Jain

34.Skin and Muscle Grafts296

Upender Sharma

35.Creation of Neovagina305

Gita Radhakrishnan, Gunjan Singh

36.Excision of Transverse and Longitudinal Vaginal Septum312

Sumita Mehta

37.Fallopian Tube Prolapse and Tubal Ligation318

Shalini Rajaram, Namita Grover

Section VI: Surgery of Cervix

38.Cervical Biopsy Techniques325

Neerja Goel, Madhu Bagaria

39.Ablative (Cryotherapy) and Excision (LEEP) Procedures for CIN331

Neerja Bhatla, Shilpa Singla

40.Cervical Incompetence and Cervical Cerclage Techniques339

Kanwal Gujral, Nidhi Khera, Chandra Mansukhani

Section VII: Non-Descent Vaginal Hysterectomy

41.Basic and Clampless Techniques355

Shalini Rajaram, Neerja Goel

42.Volume Reductive Vaginal Hysterectomy366

Neerja Goel, Shalini Rajaram, Rachna Agarwal

43.Technique of NDVH in Nulliparous, Obese and Women with Previous Surgeries375

Shirish S Sheth, Kurush Paghdiwalla

44.Laparoscopic and Vaginal Adnexectomy392

Alka Kriplani, Sumana G, Pradeep Kumar Garg

Section VIII: Genital Fistulae, Rectal Prolapse and Stress Urinary Incontinence

45.Vesicovaginal Fistula401

JB Sharma

46.Rectovaginal Fistulae406

Sanjay Gupta

47.Rectal Prolapse with Anal Incontinence416

Arun Gupta

48.Surgery for Stress Urinary Incontinence420

Pranathi Reddy

Section IX: Postoperative Care

49.Postoperative Management in Vaginal Surgery429

Shalini Rajaram, Rashmi Khatri

50.Complications of Vaginal Surgery436

Vijay Zutshi, Sumita Mehta

Index451