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Applicable in bleeding disorders, pain, leiomyoma and endometrial hyperplasia.
- The round ligament lies anterior to the tubes and ovaries.
- The peritoneum extends further down along the cervix posteriorly than anteriorly. Its ends bluntly posteriorly and sharply anteriorly.
Optionally, remove the adnexa.
- Perform a general inspection
- Measure length, width, thickness
- The uterus is usually opened at the front in the midline, optionally with an incision towards each corner.[notes 2] Open the cavity completely, along the existing incision. The cavity is sometimes be squeezed or rolled around a leiomyoma, and you'll you have to improvise and perhaps go around the leiomyoma to open the cavity properly. Cut through the front wall into both corners.
- Inspect the mucosa. If any polyps, see Endometrial polyp
- Measure the thickness of the mucosa and myometrium
- Inspect the myometrium. If any tumor, see Smooth muscle tumor
- Shape of uterus and adnex
- Mucosa, such as smooth or irregular.
- Any polyps. Further information: Endometrial polyp
- Mucosal and endometrial thickness
- Any smooth muscle tumor. Further information: Smooth muscle tumor
=Slices for microscopy
- Four cross-sectiosn from any accompanying ectocervix. In subtotal extirpation, a cross-section is taken from the lower resection border.
- A transverse slice through the endocervix, possibly divided into two.
- One slice from the front and one from the back wall of the corpus, and one piece from each corner, including myometrium.
- Any mucosal parts with macroscopically abnormal appearance, including polyps.
- In case of endometrial hyperplasia, most of the mucosa of the corpus and fundus.
- Samples form all smooth muscle tumors >5 cm in diameter. Further information: Smooth muscle tumor