Managing complications at the time of vaginal hysterectomy

When performing bilateral salpingo-oophorectomy, a long, fine clamp, such as the M.D. Anderson clamp, can help you reach up to control the gonadal vessels in the event that you lose your initial grip on those vessels (FIGURE 8).

FIGURE 8 M.D. Anderson clampHave such a clamp on hand in the event the gonadal vessels are lost during salpingo-oophorectomy, as it allows you to reach into the pelvis and retrieve them.

Be prepared
Have a plan in place to manage any complications that arise during surgery. Just as obstetricians plan ahead to prepare for shoulder dystocia and other emergencies, gynecologic surgeons must prepare for surgical complications. Tissue extraction strategies can aid in the debulking and removal of large uteri, and the proper tools, lighting, and assistance are critical to success.

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