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Introduction

The pelvis is a conned space where portions of the urinary, genital, and intestinal tract become intimately associated. Surrounding these organ sys­tems is an extensive neural network and the major vascular supply to the pelvic organs and lower extremities. Supporting the pelvic organs with their innervations are the pelvic bones, ligaments, and muscles. The major surgical disciplines that operate within the pelvis are urology, gynecology, and colorectal surgery. A wide range of extirpative and reconstructive procedures are performed by pelvic surgeons. Other disciplines operate within the pelvis as well, including general, oncologic, orthopedic, pediatric, vascular, and plastic surgeons as well as neurosurgeons.
Diseases and other abnormalities within the connes of the pelvis fre­quently affect more than one organ system as well as the surrounding neuro­vascular structures. Less commonly, tumor extends to the boney pelvis. The intimate relationships within the pelvis preclude a clear separation of the pel­vic surgical disciplines. Complications of pelvic surgery are common to all of these disciplines. All surgeons who perform pelvic operations must have a clear understanding of the complications that may arise and their prevention, recognition, and management. As pelvic diseases and abnormalities cross organ systems and disciplines, so do the complications that arise from their surgical management.
Each pelvic surgical discipline has a range of capabilities for managing operative complications. However, a multidisciplinary approach may at times be required. In some instances, the various surgical disciplines have devel­oped specialty-specic methodology for managing similar complications.
For the reasons described above, pelvic surgery by its very nature is mul­tidisciplinary. The editors of this book are from the three pelvic surgical dis­ciplines mentioned. The contribution of chapters are by experts from these same specialties as well as the extended surgical disciplines who operate on the often challenging conditions in this complex region of female anatomy.
The main objective of this book is to give a multidisciplinary perspective on complications of female pelvic surgery.
xiii

Contents

Part I General Perioperative Considerations
1 Perioperative Venous Thromboembolism . . . . . . . . . . . . . . . . . . 3
Kristen A. Ban, Stefan D. Holubar, and Daniel L. Clarke-Pearson
2 Modern-Enhanced Recovery After Surgery (ERAS)
for Major Pelvic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Leilei Xia and Siamak Daneshmand
3 Frailty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Armin Shahrokni
4 Nutrition for the Surgical Patient . . . . . . . . . . . . . . . . . . . . . . . . 31
Richard A. Jacobson, Ankita Mishra, and Sean P. Dineen
Part II Lower Genital Tract
5 Uterine Surgery for Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Jensen Reckhow and Zaraq Khan
6 Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Jessica Selle and John Gebhart
7 Genital Tract Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Brittany L. Roberts and Rebecca G. Rogers
Part III Lower Urinary Tract
8 Operations for Stress Urinary Incontinence . . . . . . . . . . . . . . . 83
Lauren M. Conroy and O. Lenaine Westney
9 Urethral Diverticulectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Richard Lee and Leo Dreyfuss
10 Segmental or Total Female Urethrectomy . . . . . . . . . . . . . . . . . 103
Kirolos N. Meilika and Jaspreet S. Sandhu
11 Transurethral Bladder Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Joshua J. Meeks
xv
xvi
12 Partial Cystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Óscar Rodríguez Faba, Alberto Breda, and Joan Palou
13 Complications of Radical Cystectomy . . . . . . . . . . . . . . . . . . . . 129
Kelly R. Pekala and Bernard H. Bochner
14 Complications in Orthotopic Neobladders . . . . . . . . . . . . . . . . . 137
Kathrin Meisterhofer, Bastian Amend, and Arnulf Stenzl
15 Continent Cutaneous Urinary Diversion in Women . . . . . . . . . 145
Jakob Klemm, Malte W. Vetterlein, and Margit Fisch
16 Complications of Ileal Conduit Urinary Diversion:
A Comprehensive Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Timothy Donahue and Charissa Chu
Part IV Upper Urinary Tract
17 Injury Repair of Pelvic Ureter . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Kyrollis Attalla and John P. Sfakianos
18 Ureteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Jonathan Modai and Matthew D. Dunn
Contents
Part V Anus and Rectum
19 Transanal Local Excisions and Endoluminal Approaches . . . . 189
Kamil Erozkan and Emre Gorgun
20 Perianal Abscess and Fistula . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Valery Vilchez and Amy L. Lightner
21 Fecal Incontinence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Anna R. Spivak
22 Operations for Rectal Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Jennifer Shearer, Brooke Gurland, and Caitlin Bungo
Part VI Miscellaneous
23 Complications of Minimally Invasive Surgery . . . . . . . . . . . . . . 245
Dandi Huang and Kenneth H. Kim
24 Composite Pelvic Resection for Deeply
Infiltrating Endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Aparna R. Ramanathan, Rebecca E. Thompson, Elissa Trieu, and Vadim Morozov
25 Inflammatory Bowel Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Scott A. Strong
26 Complications of Resection of Retroperitoneal Tumors
in the Female Pelvis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Emmanuel Zervos and Nasreen A. Vohra
Contents
xvii
Part VII Pregnancy
27 Cesarean Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Anthony Kendle and Haywood Brown
28 Management of Ectopic Pregnancy and Surgical
Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Theresa Fisher and Kristin Powell
29 Surgical Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Christy M. Boraas and Jessika A. Ralph
30 Cesarean Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319
Brett D. Einerson and Andrew P. Soisson
Part VIII Cancer
31 Inguinal Lymphadenectomy, Radical Vulvectomy . . . . . . . . . . . 333
Clarissa Lam and Mario M. Leitao
32 Pelvic and Paraaortic Lymphadenectomy . . . . . . . . . . . . . . . . . 351
Mitchel Hoffman, Murray Shames, and Bernard H. Bochner
33 Radical Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363
Mitchel Hoffman, Nadim Bou Zgheib, Monica Avila, and Jing-Yi Chern
34 Composite Pelvic Resection for Ovarian Cancer . . . . . . . . . . . . 377
Beverly Long and William A. Cliby
35 Anal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387
Anne Macleod and Susan Galandiuk
36 Rectal and Rectosigmoid Carcinoma . . . . . . . . . . . . . . . . . . . . . 401
Michelle DeLeon and Luca Stocchi
37 Pelvic Radiation Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Sudha Amarnath
38 Pelvic Exenteration for Central Pelvic Cancer . . . . . . . . . . . . . 427
Desmond P. Barton, Owen M. Heath, Rasheed Shahnawaz, Qiu Sheng, Thompson Alan, and Kumar Pardeep
39 Resection of Recurrent Pelvic Sidewall Tumor . . . . . . . . . . . . . 439
James D. McDonald and Ricardo J. Gonzalez
40 Resection of Tumors Involving the Pelvic Girdle . . . . . . . . . . . . 449
Alexander L. Lazarides, Shawna L. Watson, Guston G. Zervoudakis, Nora L. Watson, and David M. Joyce
41 Pelvic Reconstructive Procedures . . . . . . . . . . . . . . . . . . . . . . . . 463
Julian Pribaz and Kristen Whalen
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473

Contributors

Thompson Alan Department of Uro-oncology, The Royal Marsden Foundation Trust, London, UK
Sudha Amarnath Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, OH, USA
BastianAmend Department of Urology, University Hospital of Tuebingen, Eberhard Karls University, Tuebingen, Germany
KyrollisAttalla Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
MonicaAvila Department of Gynecologic Oncology, Moftt Cancer Center and USF Morsani College of Medicine, Tampa, FL, USA
KristenA.Ban Department of Colon & Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA
DesmondP.Barton Department of Gynaecological Oncology, The Royal Marsden Foundation Trust, London, UK
BernardH.Bochner Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Urology, Weill Cornell Medical College, New York, NY, USA
Christy M. Boraas Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, Minneapolis, MN, USA
AlbertoBreda Urology Department, Universitat Autònoma de Barcelona, Fundació Puigvert, Barcelona, Spain
HaywoodBrown Obstetrics and Gynecology, University of South Florida, Tampa, FL, USA
Caitlin Bungo Department of Surgery, Division of Colorectal Surgery, Stanford University, Palo Alto, CA, USA
Jing-Yi Chern Department of Gynecologic Oncology, Moftt Cancer Center and USF Morsani College of Medicine, Tampa, FL, USA
Charissa Chu Department of Urology, University of California, San Francisco, San Francisco, CA, USA
xix
xx
Daniel L. Clarke-Pearson Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, NC, USA
William A. Cliby Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, USA
Lauren M. Conroy Department of Urology, University of Texas Health Science Center at Houston, Houston, TX, USA
SiamakDaneshmand Department of Urology, USC/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
Michelle DeLeon Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA
SeanP.Dineen GI Oncology, Moftt Cancer Center, Tampa, FL, USA
Timothy Donahue Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, USA
Leo Dreyfuss Department of Urology, Weill Cornell Medical College, NewYork Presbyterian Hospital, New York, NY, USA
Matthew D.Dunn Department of Urology, University of California Los Angeles, Los Angeles, CA, USA
Contributors
BrettD.Einerson Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, UT, USA
KamilErozkan Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
Óscar Rodríguez Faba Urology Department, Universitat Autònoma de Barcelona, Fundació Puigvert, Barcelona, Spain
MargitFisch Department of Urology, University Medical Center Hamburg­Eppendorf, Hamburg, Germany
Theresa Fisher, MD Obstetrics and Gynecology, Platte Valley Medical Center, Brighton, CO, USA
SusanGalandiuk Division of Colon & Rectal Surgery, Hiram C Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, USA
John Gebhart Department of OBGYN, Division Chair Urogynecology, Mayo Clinic, Rochester, MN, USA
RicardoJ.Gonzalez Sarcoma Department, Moftt Cancer Center, Tampa, FL, USA
Emre Gorgun Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
BrookeGurland Department of Surgery, Division of Colorectal Surgery, Stanford University, Palo Alto, CA, USA
Contributors
xxi
Owen M. Heath Department of Gynaecological Oncology, The Royal Marsden Foundation Trust, London, UK
Mitchel Hoffman Department of Gynecologic Oncology, Moftt Cancer Center, USF Morsani College of Medicine, Tampa, FL, USA
Stefan D. Holubar Department of Colon & Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA
Dandi Huang Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cedars-Sinai Medical Center, West Hollywood, CA, USA
Richard A. Jacobson GI Oncology, Moftt Cancer Center, Tampa, FL, USA
DavidM.Joyce Department of Sarcoma, Moftt Cancer Center, Tampa, FL, USA
Anthony Kendle Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of South Florida, Tampa, FL, USA
ZaraqKhan Division Chair for Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, MN, USA
KennethH. Kim Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cedars-Sinai Medical Center, West Hollywood, CA, USA
JakobKlemm Department of Urology, University Medical Center Hamburg­Eppendorf, Hamburg, Germany
ClarissaLam Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
AlexanderL. Lazarides Department of Sarcoma, Moftt Cancer Center, Tampa, FL, USA
Richard Lee Department of Urology, Weill Cornell Medical College, NewYork Presbyterian Hospital, New York, NY, USA
MarioM. Leitao Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
AmyL.Lightner Department of General Surgery, Scripps Clinic Medical Group, San Diego, CA, USA
Beverly Long Division of Gynecologic Oncology, Sarasota Memorial Healthcare System, Sarasota, FL, USA
AnneMacleod Price Institute of Surgical Research, University of Louisville, Louisville, KY, USA
xxii
JamesD.McDonald Department of Surgery, University Surgixal Oncology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
Joshua J. Meeks Departments of Urology and Biochemistry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Kirolos N. Meilika Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
Kathrin Meisterhofer Department of Urology, University Hospital of Tuebingen, Eberhard Karls University, Tuebingen, Germany
AnkitaMishra GI Oncology, Moftt Cancer Center, Tampa, FL, USA
Jonathan Modai Department of Urology, University of California Los
Angeles, Los Angeles, CA, USA
VadimMorozov Obstetrics and Gynecology, MedStar Washington Hospital Center/Georgetown University School of Medicine, Washington, DC, USA
Joan Palou Urology Department, Universitat Autònoma de Barcelona, Fundació Puigvert, Barcelona, Spain
Kumar Pardeep Department of Uro-oncology, The Royal Marsden Foundation Trust, London, UK
Contributors
KellyR.Pekala Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Kristin Powell, MD, MS Obstetrics and Gynecology, Denver Health, Denver, CO, USA
JulianPribaz Department of Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA
Jessika A. Ralph Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, Minneapolis, MN, USA
AparnaR.Ramanathan Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, MedStar Washington Hospital Center, Washington, DC, USA
JensenReckhow Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
BrittanyL.Roberts Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery Albany Medical Center, Albany, NY, USA
RebeccaG.Rogers Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery Albany Medical Center, Albany, NY, USA
Jaspreet S. Sandhu Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Contributors
xxiii
JessicaSelle Department of OBGYN, Division of Urogynecology, Mayo Clinic, Rochester, MN, USA
John P.Sfakianos Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
RasheedShahnawaz Department of Colorectal Surgery, The Royal Marsden Foundation Trust, London, UK
Armin Shahrokni Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
MurrayShames Department of Surgery, Division of Vascular Surgery, USF Morsani College of Medicine, Tampa, FL, USA
JenniferShearer Department of Surgery, Division of Colorectal Surgery, Stanford University, Palo Alto, CA, USA
Qiu Sheng Department of Colorectal Surgery, The Royal Marsden Foundation Trust, London, UK
Andrew P. Soisson Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, UT, USA
AnnaR.Spivak Cleveland Clinic Foundation, Cleveland, OH, USA
ArnulfStenzl Department of Urology, University Hospital of Tuebingen,
Eberhard Karls University, Tuebingen, Germany
Luca Stocchi Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA
Scott A. Strong Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
RebeccaE.Thompson Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, MedStar Washington Hospital Center, Washington, DC, USA
Elissa Trieu Obstetrics & Gynecology, Washington Hospital Center, Washington, DC, USA
Malte W. Vetterlein Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Valery Vilchez Division of Colon and Rectal Surgery, University of California at Irvine, Irvine, CA, USA
Nasreen A. Vohra Surgery, Division of Surgical Oncology, ECU Health Medical Center, East Carolina University, Greenville, NC, USA
NoraL. Watson Department of Sarcoma, Moftt Cancer Center, Tampa, FL, USA
Shawna L. Watson Department of Orthopaedic Surgery, University of South Florida, Tampa, FL, USA
xxiv
O. LenaineWestney Department of Urology, University of Texas—MD Anderson Cancer Center, Houston, TX, USA
KristenWhalen Department of Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA
Leilei Xia Department of Urology, USC/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
Emmanuel Zervos Surgery, Division of Surgical Oncology, ECU Health Medical Center, East Carolina University, Greenville, NC, USA
Guston G. Zervoudakis Department of Sarcoma, Moftt Cancer Center, Tampa, FL, USA
Nadim Bou Zgheib Department of Oncology, Edwards Comprehensive Cancer Center and Joan C.Edwards School of Medicine, Huntington, WV, USA
Contributors