The whole process of cervical conization surgery

Cervical conization, also known as cervical cone extraction surgery; conization of uterine cervix; cervical cone extraction; cervical cone extraction surgery. Contraindications include acute genital inflammation, genital tract infection, cervical invasive cancer, genital malformation, blood disease, and severe bleeding tendency.

Scope of application of cervical conization

Cervical conization is suitable for:

1. Cervical puncture biopsy is performed for carcinoma in situ to clarify the extent of the disease and whether there is any invasion.

2. Moderate to severe atypical hyperplasia of the cervix.

3. Those whose cervical smears are positive for several times, but the puncture biopsy cannot detect the disease.

Preparation before cervical conization surgery

1. Surgery should be performed 3 to 7 days after the end of menstruation to avoid surgery before menstruation.

2. Check secretions, cervical smears, and cervical puncture biopsy when necessary, and routine blood tests including platelets, bleeding, and clotting time.

3. Three days before surgery, irrigate or clean the vagina and cervix with 0.05% chlorhexidine (chlorhexidine) solution once a day.

Anesthesia and position for cervical conization

Sacral or spinal anesthesia. Take the lithotomy position for the bladder.

Cervical Conization Procedure

1. Basic disinfection and sterilization of private parts, vagina and cervix, spread disinfectant towel.

2. Use a retractor in the vagina to expose the cervix, and apply iodine solution to the entire cervix to determine the extent of the disease. Use rat-tooth forceps to clamp the cervix in the area not colored by iodine and gently pull the belt downward. A metal catheter is inserted into the bladder to measure the level of blood flow at the lower edge of the bladder.

3. Use surgical forceps to make a circular incision in a vertical position 0.3 to 0.5 cm outside the cervical disease, tilt it inward by 30° to 40°, and slowly perform a cone-shaped removal towards the shallow layer of the cervix. Note that the cone tip should be pointing toward the internal cervical os and the position should not be tilted so that the cervical tissue can be cut in a complete cone shape. Generally, the cone bottom width is 2 to 3 cm and the cone height is about 2.5 cm. But it should not exceed the internal os of the cervix. If there are blood spots on the cervical wound, you can use 3-0 intestinal suture or electrocautery to activate blood circulation, and seal part of it with gauze and remove it after 24 hours.

4. Surgical suture of the cervix is ​​seen during cervical resection, but it is not necessarily required.

Key points to note during cervical conization

1. The top of the cervical incision should be consistent with the position of the internal opening. If it is cut obliquely or too much, it may injure the surrounding tissues or cause internal bleeding.

2. The removal range should include the diseased area of ​​cervix and most of the endocervical tissue to avoid incomplete examination of the disease due to cutting too little or too shallow.

3. Take out the cervical specimen and collect it. Pass a thread through the 12 o'clock position as a mark to facilitate the identification of the diseased location.