No..

MR

49

12

06

00

RUMAH SAKIT UMUM FKUKI

SMF OBSTETRI GINEKOLOGI
Jl. Mayjen Sutoyo no. 2, Cawang, Jakarta Timur, 13630
Tel. 021 8092317 ext. 108 / 205

Name: Mrs. Dermawaty

Operator
Prof.dr.I.O.Marsis, SpOG
Asistant 1
Dr. Benhur
Asistant 2
Clara Bulan A. Banurea
Pre-surgery diagnose: Mioma Uteri
Post- surgery diagnose: Mioma Uteri

Sex: Female
Anestetic
Instrumentator
Observer

Technique of operation
1.Total Hysterectomy

Age: 55
dr. Veronica Manurung, SpAn
Zr. Sumarni
Theresia Lasma L. Hutabarat
Surgery date: February 11th 2016
Duration time of surgery: 2 hour
Type of surgery
emergency minor
policlinic
medium
elective
major

SURGERY REPORT

OPERATION PROCEDURES:
I

Patient was administered with general analgesia in supine position

Operation Report / Obsgyn RSU FK UKI

II

Asepsis and antisepsis in intern genitalia with betadine and methyline blue

III.
IV.

Dower catheter was inserted into external urethral ostium

Asepsis and antisepsis in abdomen regio with betadine and then field of view
narrowed by steril doek.

V.

Opened the abdominal wall.

a. Median incision on abdomen was made around fibritio tissue, 15 cm length,
the incision was made deeper slice by slice from cutis, subcutis, fascia then
it separated to lateral section with sharp technique. Musculus rectus
abdominis separated with dull technique, bleeding was taken care off.
b. Applying hashbach in to abdominal cavity to separating uterus with other
organ.

VI.

Explored the abdominal and pelvic cavity

a. Identified:
-

The uterine as big as a baby head with slippery surface without

adhesion

Both of tuba are normal

Both of ovarium are normal

Conclusion: Mioma uteri

b. Based on the abnormality, total hysterectomy was planned

VII. Operative Procedures of Total Hysterectomy as follows
a. Fixation uterus by drill
b. The round ligament clamped on two side, approximately 1 cm and 1,5 cm from
uterus and then cut both two clamp, ligated at medial and lateral dissection,
then sutured it by Vicrylno.1. The same procedure is done on both sides.
c. Opened plica vesikouterina and continued incision to the left and right lateral
and put aside to lower.
d. The proximal of left fallopian tube was clamped on two side, cut both two
clamped ligated on medial and lateral dissection and then sutured with
Vicrylno.1. The same procedure is done on the right fallopian tube.
e. The left broad ligament clamped on two side, cut both two clamped, ligated,
then sutured. The same procedure is done on the right broad ligament.
f. The left uterosacral ligament clamped on two side, approximately 1 cm and 1,5
cm from uterus, cut between two clamped, ligated on medial and lateral

Operation Report / Obsgyn RSU FK UKI

dissection then sutured with Vicrylno.1. The same procedure is done on the
right uterosacral ligament.
g. The left and right vasa uterin clamped, cut and ligated with Vicrylno.1
h. The left cardinale ligament clamped on two side, cut between two clamped,
ligated on medial and lateral dissection, then sutured. The same procedure is
done on the right cardinale ligament.
i. Cut off the corpus utery till supracervix and sutured with Vicryl no.1 by
overhecting suture. And hanged with the right and left round ligament, the right
and left uterosacral ligament and the proximal of right and left fallopian tube.
j. Do suture hemostasis in the lower uterine segment at both ends with "vicryl"
no.2.0 Then baste the myometrium stitched interlocking, followed by sewing
cords and vesico uterine myometrium in baste with "vicryl" no.2.0
k. Then after suturing the uterus, followed by action incision myoma uteri
gradually, and do suturing.
l. NaCl was administered to the whole abdominal cavity to make sure there was
no bleeding.
VIII.

After the reperitonealization had been done abdominal wall was closed, the
peritoneum cavity was cleared from the blood cloth and after sure its no
bleeding then it was sutured slice by slice.
a. Peritoneum parietal was sewed bastes with Plain cat gutno.2.0, before
that the cortisone asetat 25 mg/10ml was pulled in
b. M.Rectus abdominis was sutured with Chromic cat gut no.2.0
c. Fascia was sutured with Polysorbno.1 by simple suture.
d. Subcutis was sutured with Plain cat gut no.0 by simple suture
e. Cutis was sutured with Chromic cat gut no. 2.0 by subcuticuler

IX.

Bleeding approximately 200cc

X.

Post surgical wound was cleaned by using Nacl + Betadine, and then it was
closed by using the curapor.

XI.

The vagina was cleaned.

XII.

The surgery finished.

Post surgery condition:

Operation Report / Obsgyn RSU FK UKI

General condition

: Moderate illness

Consciousness

: Composmentis

Blood pressure

:130/90 mmHg

Pulse rate

: 84 x/mnt

Respiratory Rate

: 24 x/mnt

Temperature

: 36,8oC

Tissue to Anatomy Patological

Yes: type of tissue : Adenomyoma (19 Desember 2014)
No

Operator,

( Prof.dr.I.O.Marsis, SpOG )

Operation Report / Obsgyn RSU FK UKI