Title

Importance of Planning for Unexpected Intraoperative Events

Document Type

Conference Proceeding

Publication Date

10-10-2021

Abstract

A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.A 32-year-old G2P1102 female with history of two prior c-sections was scheduled for a one-hour long diagnostic hysteroscopy and IUD removal due to dyspareunia. Pre-op TVUS and abdominal X-ray demonstrated a misaligned IUD without complete confirmation of intrauterine location. After an uneventful induction and LMA placement, failure to locate IUD led to intraoperative conversion to a diagnostic laparoscopy that included a meticulous search of the abdomen and pelvis. An additional 4 hours of operative time was spent releasing the IUD from densely adherent omentum. We discuss management strategies for unforeseen intraoperative events and changes to the original surgical plan.

Comments

American Society of Anesthesiology Annual Meeting, San Diego, CA, October 8-12, 2021.

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