Reasons of MDT gynaecological operations
An analysis was completed on the reasons of MDT gynaecological
operations described in Table 3. We judged the reasons through the
description in the surgical record of 39 patients. As a result, six main
reasons were summarized.
The most common situation was the diseases spread to other organs,
especially in patients with malignant tumors and deep infiltrating
endometriosis. There were 26 cases using MDT surgical pattern because of
widespread metastasis to achieve the aim of complete resection. Surgical
area included partial liver resection, sigmoid colon and rectum
resection, bladder and ureter resection. All the tissues removed were
proved to be the metastases of the primary disease by pathological
result.
Other reasons were less common. Three patients received MDT
gynaecological surgeries passively because vice-damage appeared during
operation. Case 14 accepted a rectal repair as a result of rectum injury
caused by separation of adhesions. Case 34 and case 38 received vascular
repairs and both of them conversed to open surgeries. Three patients
adopted robotic-assisted MDT gynaecological surgeries because they
suffered from ureteral fistula or ureterovaginal fistula after radical
hysterectomy. Only one patient needed MDT pattern to acquire
intraoperative assistance in judging the condition of metastasis. An
unexpected cystoscopy was used to rule out ureteral endometriosis for
case 36. Due to the complexity of pelvic anatomy, it was advised to call
for cooperation with other departments when separating severe adhesions.
And we followed the rules during the surgeries of 3 patients. A small
number of patients asked to solve their other non-gynaecological primary
diseases in the operation. Case 11 received a right kidney tumor
resection during the robotic-assisted pelvic and para-aortic lymph node
dissection. A partial small intestine resection and anastomosis was
accomplished for case 31 who was discovered small bowel diverticulum,
while a cholecystectomy was carried out for case 35 who was diagnosed
with cholecystitis.