SISTIM PELAYANAN

INSTALASIPREPARATION
PREOPERATIVE BEDAH PUSATFOR
RSGYNECOLOGY
CIPTO MANGUNKUSUMO
SURGERY

dr DR Gatot purwoto, SPOG(K)

Dr dr Gatot Purwoto, SpOGK
2015
APCGS
Jakarta, 4-6 Oktobwe 2015

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 Definition

Aassessment of a patient before surgery

to detect factors that could affect
surgical outcome and may include
physical examination, laboratory testing,
imaging and consultations

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Gynecology surgery

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 Objectives

Pre-operative preparation :
Laboratory
CXR
EKG, echocardiography
Imaging
BNO IVP
Blood preparation
ICU, Intermidiate care unit
Informed concent
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 LABORATORY

Hb, Ht, L, Tr
Bleeding time, Clotting time
SGOT. SGPT, albumin
Ureum, Creatinin
Elektrolit (Na, K, Cl)
Gula darah (N, PP, GDS)

HbsAg. HIV

Tumor marker (by indication)

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 CHEST X RAY

Lung & Cardiac evaluation

Pleural effusion
Bronchopneumonia
Lung metastasis
Cardiomegaly

Spirometry restricton level

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 EKG, ECHOCARDIOGRAPHY

Simple cardiology evaluation

Echocardiography
Cardiac morphology
Cardiac functiom

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 IMAGING

Depending on the kind of desaese

USG (abdominal, transvaginal)

Morpholgy
Doppler
CT scan
Helical
W/WO contrast
MRI
Resonance imaging
PET scan (FDG cancer detection)

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 BNO IVP

Renal function

Risk of Urology tract injury

Ureter catheter
Double J stent catheter

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 BLOOD PREPARATION

Indication by estimation
PRC
WB
FFP

Risk of massive or serious beleeding

Long operation
Severe adhesion

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 ICU

Indication by risk
Risk of Bleeding
Risk airway problem
Risk of cardio-pulmonary problem

ICU
HCU

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 IINFORMED CONCENT

Definive planning of surgery

procedure

Risk of Complication
Prognosis
Site of marking

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 ANTIBIOTIC

Prophilaxys antibiotic
Single dose
Narrow spectrum

May coniunued with empirical

antibioticsd

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 TAKE HOME MASAGES

Pre-operative preparation will improve

successfulness of surgery

Optimal preparation may minimize serious

unpredictable complication

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Terima kasih

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