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.