Operating Room Gynecology

I spent this week with the benign gynecology team. It felt very surgical. There is a small inpatient service at Mount Zion (one of UCSF's satellite campuses) and most of our day is occupied by operations. Over the week, we've had a few operative hysteroscopies, using a scope to look inside the uterus to assess for things like fibroids, retained products of conception, and arterio-venous malformations. We've had a laparoscopic ovarian cystectomy and an open ovarian cystectomy, a laparoscopic hysterectomy and an open one, and an abdominal myomectomy. It's always fascinating seeing the same procedures done in different fashions for various reasons (for example, we were worried that one rapidly growing fibroid was a leiomyosarcoma so we did it open instead of laparoscopic). I've also seen a few D&C's (dilatation of the cervix and curettage of the uterus).

It's fun being in the operating room. It reminds me strongly of surgery. I like the setting and the satisfaction of dissecting out the pathology. It's nice to have familiarity with the tools, approaches, thought process, and techniques of surgery. I also realize that an ob/gyn's surgical repertoire is fairly limited. Even though they do laparoscopic, open abdominal, and transcervical procedures, the bulk of diseases I saw involved fibroids, ovarian cysts, uterine bleeding, and pelvic pain (there's also the field of female incontinence).