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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_207_библиотеки_им_акад_М_И_Перельмана
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Step 11
Identification of the cleavage plane between cyst wall and ovarian cortex.
See Te ch Figure 6.2.5.
Te ch Fig ure 6.2.5. Identification of the cleavage plane between cyst wall and ovarian cortex by injection of saline.
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Step 12
Cyst wall stripped off the remaining ovarian parenchyma through traction exerted in opposite directions by using two
atraumatic grasping forceps.
See Te ch Figure 6.2.6.
Te ch Fig ure 6.2.6. Cyst wall stripped off t he remaining ovarian parenchyma through tract ion exerted in opposite directions by using two atraumat ic grasping
forceps.
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Step 13
Remove cyst wall through trocar or in bag.
See Te ch Figure 6.2.7.
Te ch Fig ure 6.2.7. Remove cyst wall through trocar or in bag.
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Step 14
Hemostasis obtained with suture or sealant. Bipolar desiccation for hemostasis may harm ovarian reserve.
37,38
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Step 15
Sutures may be placed for approximation of the ovarian edges.
See Te ch Figure 6.2.8.
Te ch Fig ure 6.2.8. Sut ures may be placed for approximat ion of t he ovarian edges.
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Step 16
Washing and aspirating saline.
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Step 17
Eliminating pneumoperitoneum.
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Step 18
Removing trocars and closure of the skin incisions.
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PEARLS AND PITFALLS
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POSTOPERATIVE CARE
The patient can attempt to conceive immediately following surgery. If unable to conceive after 6 to 12 months of appropriate
timed intercourse, the patient should consider IVF.
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