Name of the Procedure:

Hysterorrhaphy of Ruptured Uterus
Common Name: Uterine Repair Surgery
Medical Term: Hysterorrhaphy

Summary

The Hysterorrhaphy procedure is a surgical operation to repair a ruptured uterus. The uterus may rupture due to various factors, such as trauma, labor complications, or weak uterine muscles. This surgery aims to restore the integrity of the uterine wall to ensure proper healing and function.

Purpose

The primary purpose of this procedure is to address and repair a uterus that has ruptured. This can prevent excessive bleeding, infection, and ensure the safe recovery of the patient. The expected outcome is the restored integrity and normal function of the uterus.

Indications

Indications for hysterorrhaphy include:

• Acute abdominal pain and signs of internal bleeding during labor or delivery.
• Confirmed diagnosis of uterine rupture via ultrasound or other imaging techniques.
• History of uterine surgeries, such as cesarean sections, leading to a higher risk of rupture.
• Physical examination and symptoms indicating a rupture.

Preparation

Pre-procedure instructions for the patient typically include:

• Fasting for at least 8-12 hours prior to surgery.
• Adjusting or stopping certain medications, especially blood thinners, as advised by the physician.
• Undergoing diagnostic tests such as ultrasounds, blood tests, or an MRI to confirm the rupture and plan the surgery.

Procedure Description

1. The patient is administered general anesthesia to ensure they are asleep and pain-free during the surgery.
2. A sterile field is created, and an incision is made in the abdomen to access the uterus.
3. The ruptured area of the uterus is identified, and any bleeding vessels are controlled.
4. The surgeon uses sutures to close the rupture, carefully stitching the uterine muscle and any layers involved.
5. After ensuring proper hemostasis and checking for any remaining issues, the abdominal incision is closed with sutures or staples.
6. The patient is moved to a recovery area for monitoring.

Tools and Equipment: Surgical sutures, clamps, surgical instruments for opening and closing the incision.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and extent of the rupture.

Setting

Hysterorrhaphy is performed in a hospital setting, usually in an operating room equipped for major surgical procedures.

Personnel

The surgical team involved typically includes:

• A lead surgeon (often a gynecologist or obstetrician).
• Surgical assistants/nurses.
• An anesthesiologist to manage anesthesia.
• Scrub nurses or surgical technologists.

Risks and Complications

Common risks include:

• Infection
• Bleeding
• Damage to surrounding organs
• Blood clots
• Adverse reactions to anesthesia

Rare complications could include:

• Uterine scarring or adhesions, affecting future pregnancies.
• Prolonged recovery or additional surgeries if the repair fails.

Benefits

The primary benefit is the repair of the uterus, which can prevent life-threatening complications such as severe bleeding and infection. Benefits are often realized immediately post-surgery, with gradual improvement as recovery progresses.

Recovery

Post-procedure care involves:

• Hospital stay for a few days for monitoring.
• Pain management with prescribed medications.
• Avoiding strenuous activities and heavy lifting for several weeks.
• Follow-up appointments to monitor healing and address any concerns.

Alternatives

Alternative treatment options might include:

• Emergency hysterectomy if the uterus cannot be repaired.
• Conservative management in very rare cases with minimal rupture and stable condition. Compared to these alternatives, hysterorrhaphy aims to preserve the uterus and its functions, particularly important for women desiring future pregnancies.

Patient Experience

Patients will likely experience discomfort and pain at the incision site post-surgery, managed with pain relief medications. Over time, with proper care and follow-up, most patients can resume normal activities and potentially have a healthy pregnancy in the future, if desired.