Cervical colonization cold knife Endocervical curettings

ANESTHESIA:  General, conscious sedation.

PREOPERATIVE DIAGNOSIS:  Cervical dysplasia.

POSTOPERATIVE DIAGNOSIS:  Cervical dysplasia.

OPERATION PERFORMED:

1.  Cervical colonization, cold knife.

2.  Endocervical curettings.

COMPLICATIONS:  None.

ESTIMATED BLOOD LOSS:  Less than 30 mL.

DISPOSITION:  The patient was transferred to the recovery room in a stable condition.

JUSTIFICATION:  The patient presented on 05/15/09 for the above procedures, for the above diagnosis.  The patient understands the indications, rationale, potential complications, and risks.  She is aware that these risks include infection, bleeding, injury to adjacent structures such as the bowel or bladder as well as potential cardiac or pulmonary complications, and risk of anesthesia.  The patient is aware of the potential for thromboembolic events including deep venous thrombosis, stroke, and pulmonary embolus.  She is aware of the potential for alteration in the cervical anatomy including potential future limitations for pregnancy carriage and fertility.  All of the patient's questions have been answered apparently to her satisfaction.  The patient has elected to proceed with surgery and is medically cleared.

PROCEDURE IN DETAIL:  Following documentation of informed consent for the above procedures, the patient was brought to the operative suite where she was administered general anesthesia, prepped and draped in the usual sterile fashion in the low lithotomy position in Allen stirrups.  A weighted speculum was placed in the vaginal vault.  A single tooth tenaculum was placed on the anterior lip of the cervix.  The cervix was infiltrated with dilute pitressin solution.  Excision of the transformation zone was accomplished to a level approximating 3 to 4 mm depth.  Top hat samples were taken above the resection margin with the LEEP electrode.  Endocervical curettings were sampled above the top hat.  Exact hemostasis was secured within the resection bed utilizing the Bovie ball cautery.  Mastisol solution was applied to promote ongoing hemostasis.  All instruments were removed from the vagina and perineum.  The patient was awakened from anesthesia and returned to the recovery room in a stable condition.