Bonney's Gynaecological Surgery 11th ed - T. Lopes, et al., (Wiley-Blackwell, 2011) WW

284 Pages·2011·10.58 MB·English

Bonney’s Gynaecological Surgery

This book is dedicated to the memory of Victor Bonney.
It is also dedicated to Jane, Vicki, Roopal and Maggie for their support, understanding,
patience and love, which they have shown us in our lives together .

Bonney’s Gynaecological
Surgery

Tito Lopes

MBChB, FRCOG
Consultant Gynaecological Oncologist
Royal Cornwall Hospital
Truro
UK

Nick M. Spirtos

MD
Professor and Vice-Chairman, Department of Obstetrics and Gynecology
Director, Division of Gynecologic Oncology, University of Nevada School of
Medicine, Reno, and the Women’s Cancer Center of Nevada, Las Vegas
NV, USA

Raj Naik

MD, FRCOG
Consultant Gynaecological Oncologist and Surgeon
Clinical Director of the Northern Gynaecological Oncology Centre
Queen Elizabeth Hospital
Gateshead
UK

John M. Monaghan

MB, FRCS (Ed), FRCOG
Retired Senior Lecturer in Gynaecological Oncology, University
of Newcastle Upon Tyne
Retired Gynaecological Oncologist, Regional Department of
Gynaecological Oncology
Queen Elizabeth Hospital
Gateshead
UK

ELEVENTH EDITION

A John Wiley & Sons, Ltd., Publication

This edition fi rst published 2011 © 1911, 1974, 1986, 2004, 2011 by Tito Lopes, Nick M. Spirtos, Raj Naik, John M. Monaghan

Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been
merged with Wiley’s global Scientifi c, Technical and Medical business to form Wiley-Blackwell.

Registered offi ce: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offi ces: 9600 Garsington Road, Oxford, OX4 2DQ, UK

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offi ces, for customer services and for information about how to apply for permission to
reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell

The right of the author to be identifi ed as the author of this work has been asserted in accordance with the Copyright,
Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any
form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK
Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available
in electronic books.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and
product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective
owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed
to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding
that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is
required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientifi c research, understanding, and discussion only and are
not intended and should not be relied upon as recommending or promoting a specifi c method, diagnosis, or treatment by
physicians for any particular patient. The publisher and the author make no representations or warranties with respect to
the accuracy or completeness of the contents of this work and specifi cally disclaim all warranties, including without
limitation any implied warranties of fi tness for a particular purpose. In view of ongoing research, equipment modifi cations,
changes in governmental regulations, and the constant fl ow of information relating to the use of medicines, equipment,
and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for
each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and
for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an
organization or Website is referred to in this work as a citation and/or a potential source of further information does not
mean that the author or the publisher endorses the information the organization or Website may provide or
recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have
changed or disappeared between when this work was written and when it is read. No warranty may be created or
extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any
damages arising herefrom.

Library of Congress Cataloging-in-Publication Data
Bonney’s gynaecological surgery. – 11th ed. / Tito Lopes ... [et al.].
p. ; cm.
Other title: Gynaecological surgery
Includes bibliographical references and index.
ISBN 978-1-4051-9565-2
1. Generative organs, Female–Surgery. I. Lopes, Tito. II. Bonney, Victor, 1872–1953. Gynaecological
surgery. III. Title: Gynaecological surgery.
[DNLM: 1. Gynecologic Surgical Procedures. 2. Genitalia, Female–surgery. WP 660 B7171 2010]
RG104.B65 2010
618.1–dc22

2010015117

ISBN: 9781405195652

A catalogue record for this book is available from the British Library.

This book is published in the following electronic format: ePDF 9781444325232; Wiley Online Library 9781444325225

Set in 9/11.5 pt Sabon by Toppan Best-set Premedia Limited

01 2011

v

Contents

Preface to the eleventh edition, vii
Preface to the ninth edition, ix

Part 1: General
1 Introduction and prologue, 3
2 Preparation for surgery, 7
3 Instruments, operative materials and basic surgical techniques, 15
4 Opening and closing the abdominal cavity, 31
5 The laparoscopic approach in gynaecology, 42
6 Postoperative care and complications, 52

Part 2: Anatomical
For the general gynaecologist and gynaecologist in training
7 Operations on the vulva, 59
8 Operations on the vagina, 66
9 Operations on the cervix, 81
10 Operations on the uterine cavity, 99
11 Operations on the uterus, 105
12 Uterine fi broids, 121
13 Operations on the fallopian tubes, 125
14 Operations on the ovaries, 131
15 Caesarean section, 136

Part 3: Condition
Recognition of surgical special interest and subspecialties
Urinary/pelvic fl oor
16 Operations for pelvic organ prolapse, 149
Gillian E. Fowler and David H. Richmond
17 Operations for urinary incontinence, 161
David H. Richmond
18 Operations for the correction of urinary fi stulae, 175
David H. Richmond

CONTENTS

vi

Oncology
19 Surgery for carcinoma of the vulva, 181
20 Vaginal cancer surgery, 190
21 Cervical cancer, 192
22 Uterine cancer, 216
23 Ovarian cancer, 219
24 Exenterative surgery, 222

Operations on other organs
25 Vascular surgery: applications in gynaecology and
gynaecological oncology, 231
26 Urinary tract, 235
27 Operations on the intestinal tract for the gynaecologist, 250
28 Reconstructive procedures, 260

Index, 263

vii

Preface to the e leventh e dition

Next year, Bonney ’ s Gynaecological Surgery cele-
brates its 100th birthday, the fi rst edition having been
published in 1911 by Comyns Berkeley and Victor
Bonney. In those 100 years, major advances in anaes-
thetics, transfusion services, antibiotics and instru-
ment development have not only resulted in safer
surgery for the patient but also have allowed increas-
ing innovation in surgical procedures.
In gynaecology this is exemplifi ed by the almost
routine use of minimal access techniques in everyday
practice, as well as the increasing surgical options in
the urological and oncological subspecialties.
Despite these advances, many of the basic surgical
principles remain unchanged, and this is highlighted
by the retention in this edition of some of Bonney ’ s
original drawings 100 years on.
Three of the current editors have worked in the
department of gynaecological oncology in Gateshead
started by Stanley Way in 1948. It is therefore not
surprising that this 11th edition refl ects an evolution
rather than a revolution from the 9th edition edited
by John Monaghan in 1986, the preface of which
follows this current preface.
As with previous editors, I have taken the liberty
of removing elements from the last edition which are
no longer relevant to current practice. The format
has also changed and the current edition is divided
into three sections. The fi rst section, covering general
principles and basic techniques, lays the foundation
for any trainee wishing to develop into a competent
gynaecological surgeon. The second section, presented
by anatomical site, covers the common procedures
undertaken in day - to - day benign gynaecology. The

last section recognizes the two surgical subspecialties
of urogynaecology and gynaecological oncology.
Although several of the procedures described are cur-
rently undertaken by the experienced generalist as
well as the specialist, this is becoming less common,
especially in cancer surgery. This section also covers
surgery for other sites that may arise during gynaeco-
logical surgery, either as a planned procedure or as
the result of an unexpected fi nding or complication.
Although rarely encountered in general gynaecology,
and usually within the remit of one ’ s surgical col-
leagues, it is important to understand the principles
of the procedures involved.
As the senior editor I am indebted to John Monaghan
and Raj Naik for their continued support and I am
extremely grateful to Nick Spirtos for agreeing to join
us in editing this current edition. His skills in both
laparoscopic and radical open surgery are recognized
internationally and his methodical approach to these
procedures is refl ected in his contributions to the
book. I also wish to thank David Richmond and
Gillian Fowler for their contributions to the section
on urogynaecology.
Lastly, my thanks to Wiley - Blackwell and espe-
cially to publisher Martin Sugden for inviting me to
lead on this edition of Bonney ’ s Gynaecological
Surgery . The support and encouragement of their
team along with that of Lindsey Williams has made
the whole process a pleasure.

Tito Lopes
Truro, Cornwall
September 2010