23 Gynecological and Obstetrical Surgery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 23.1: Anatomy and Diagnostics
- 1. Identify key anatomical structures of the female reproductive system
- 2. Discuss common diagnostic procedures of the female reproductive system
Lesson 23.2: Case Planning and Techniques
- 3. Discuss specific elements of case planning for gynecological and obstetrical surgery
- 4. Discuss surgical techniques used in gynecological and reproductive surgery
Lesson 23.3: Common Surgical Procedures
- 5. List and describe common gynecological and obstetrical procedures
Classroom Preparation
Lesson 23.1: Anatomy and Diagnostics
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Identify key anatomical structures of the female reproductive system
- 2. Discuss common diagnostic procedures of the female reproductive system
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 23.1: Anatomy and Diagnostics
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction—Gynecologics • Surgical Anatomy of the Female Reproductive System Uterus Fallopian Tubes Ovaries Vagina Vulva • Ovarian (Menstrual) Cycle • Introduction—Operative Obstetrical Procedures • Stages of Pregnancy • Complications of Pregnancy Placental Abruption Placenta Previa Pregnancy-induced Hypertension Nuchal Cord Lack of Labor Progress Cord Prolapse Breech Presentation ANSWER – Workbook • Chapter 23 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Diagnostic Procedures Patient History and Physical Examination Preoperative Malignancy Screening Imaging Techniques Cervical and Endometrial Biopsy Cone Biopsy of the Cervix • Psychosocial Considerations • Diagnostic Tests ANSWER – Workbook • Chapter 23 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 23.1: Anatomy and Diagnostics
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | ANATOMY: SLIDES 4-7 | • Introduction—Gynecologics • Surgical Anatomy of the Female Reproductive System Uterus Fallopian Tubes Ovaries Vagina Vulva • Ovarian (Menstrual) Cycle • Introduction—Operative Obstetrical Procedures • Stages of Pregnancy • Complications of Pregnancy Placental Abruption Placenta Previa Pregnancy-induced Hypertension Nuchal Cord Lack of Labor Progress Cord Prolapse Breech Presentation |
| 2 | DIAGNOSTICS: SLIDES 8-10 | • Diagnostic Procedures Patient History and Physical Examination Preoperative Malignancy Screening Imaging Techniques Cervical and Endometrial Biopsy Cone Biopsy of the Cervix • Psychosocial Considerations • Diagnostic Tests |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (30 min) • Discuss the complications of pregnancy and the implications for the surgical technologist. • Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (20 min) • As a class, discuss the patient history in gynecological and obstetrical procedures. What is the importance of each specific area of the history? How does the process differ from nongynecological patient histories? • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Why might a patient need or want each of the described abortions listed in the text? What are the possible special needs of a patient who is undergoing an abortion?
Discussion Guidelines: Students should identify that many factors may influence a patient’s choice or need for an abortion. It may be fetal demise, severe disease, or defect of the fetus. It could be a case of rape. The health of the mother could be in jeopardy. Students need to understand that they may never completely understand the patient’s position, so they should not assume the worst. It is important to be supportive and nonjudgmental. Surgical technologists who have ethical concerns about abortions and who do not, for these reasons, want to participate in abortions should notify their employer either at the time of their hiring or as soon as possible following their decision. It is too late to refuse to participate in an abortion if you are already in the process of preparing for the procedure or if the procedure is in progress.
Classroom Preparation
Lesson 23.2: Case Planning and Techniques
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 3. Discuss specific elements of case planning for gynecological and obstetrical surgery
- 4. Discuss surgical techniques used in gynecological and reproductive surgery
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 23.2: Case Planning and Techniques
STUDENT PREPARATION (1 hr)
| 3 | READ – Chapter Heading(s) • Case Planning Positioning Team Positioning Skin Prep and Draping Instruments Equipment and Supplies Drugs Sutures ANSWER – Textbook • Review Questions 1, 2, 4 ANSWER – Workbook • Chapter 23 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Abdominal Procedures Diagnostic Laparoscopy ANSWER – Textbook • Review Question 5 ANSWER – Workbook • Chapter 23 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 23.2: Case Planning and Techniques
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 3 | CASE PLANNING: SLIDE 12 | • Case Planning Positioning Team Positioning Skin Prep and Draping Instruments Equipment and Supplies Drugs • Sutures |
| 4 | SURGICAL TECHNIQUES: SLIDES 13 | • Abdominal Procedures Diagnostic Laparoscopy |
Learning Activities (choose one or more to equal 50 min)
| 3 | DISCUSS (30 min) • Discuss specific elements of case planning for gynecological and obstetrical surgery. Appropriate Settings: Traditional/online/flipped classroom |
| 4 | DEMONSTRATE (50 min) • Using a guest volunteer or a student, demonstrate the placement of Mayo stand, back table, and surgical team for vaginal procedures. Demonstrate passing instrumentation for when the scrub stands beside the surgeon and when the scrub stands behind the surgeon. Identify and discuss possible “danger zones” for contamination and how to avoid breaches in technique. Appropriate Settings: Traditional classroom |
Critical Thinking Question
If a gynecological procedure is performed laparoscopically (via the abdomen), why are the perineum and vagina prepped and draped?
Discussion Guidelines: Most gynecological laparoscopic procedures require a D&C (dilation & curettage) to be performed first and then a uterine manipulator is inserted through the vagina and into the cervix.
Classroom Preparation
Lesson 23.3: Common Surgical Procedures
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 5. List and describe common gynecological and obstetrical procedures
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 23.3: Common Surgical Procedures
STUDENT PREPARATION (1 hr)
| 5 | READ – Chapter Heading(s) • Transcervical Procedures Hysteroscopy Hysterscope Imaging System Resectoscope Operating Instruments • Transvaginal Procedures Hysteroscopic Endometrial Ablation Myomectomy Dilation and Curettage Vaginal Hysterectomy Repair of a Cystocele and Rectocele (Anterior-Posterior Repair) Repair of a Vesicovaginal Fistula Pathology • Procedures of the Vulva Removal of a Bartholin Gland Cyst Simple Vulvectomy Removal of Condyloma Acuminata • Abdominal Procedures Laparoscopic Tubal Ligation Laparoscopic Management of an Ovarian Cyst Tuboplasty Surgical Management of an Ectopic Pregnancy Laparoscopic-Assisted Vaginal Hysterectomy Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy Robotic-Assisted Hysterectomy Radical Hysterectomy with Lymphadenectomy Pelvic Exenteration • Normal Vaginal Delivery • Immediate Postpartum Care • Newborn Care • Obstetrical Procedures Episiotomy Cesarean Delivery ANSWER – Textbook • Review Questions 3, 6, 7, 8, 9, 10 ANSWER – Workbook • Chapter 23 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 23.3: Common Surgical Procedures
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 5 | COMMON SURGICAL PROCEDURES: SLIDES 15-21 | • Transcervical Procedures Hysteroscopy Hysterscope Imaging System Resectoscope Operating Instruments • Transvaginal Procedures Hysteroscopic Endometrial Ablation Myomectomy Dilation and Curettage Vaginal Hysterectomy Repair of a Cystocele and Rectocele (Anterior-Posterior Repair) Repair of a Vesicovaginal Fistula Pathology • Procedures of the Vulva Removal of a Bartholin Gland Cyst Simple Vulvectomy Removal of Condyloma Acuminata • Abdominal Procedures Laparoscopic Tubal Ligation Laparoscopic Management of an Ovarian Cyst Tuboplasty Surgical Management of an Ectopic Pregnancy Laparoscopic-Assisted Vaginal Hysterectomy Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy Robotic-Assisted Hysterectomy Radical Hysterectomy with Lymphadenectomy Pelvic Exenteration • Normal Vaginal Delivery • Immediate Postpartum Care • Newborn Care • Obstetrical Procedures Episiotomy Cesarean Delivery |
Learning Activities (choose one or more to equal 50 min)
| 5 | DISCUSS (50 min) • Break into small groups. Provide each group with a blank transparency and a marker. Each group should draw a rectangle suggestive of a Mayo tray. They should depict a setup for hysteroscopy by drawing or writing instrument names on the “tray.” Have a spokesperson from each group share the group’s work and the rationale for the selections. If time is short, the instructor can draw a rectangle on the board and have individual students add the instruments to the drawing. • Break the class into small groups. Ask each group to discuss vesicovaginal and rectovaginal fistulas. What are the causes of fistulas and how are they surgically repaired? The groups should also discuss the complications of fistulas and their psychological and social impacts. Have volunteers from each group present their ideas to the class. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Another member of the surgical team has committed a break in technique during a vaginal procedure. After you have called attention to the breach, the team member states, “It’s all dirty anyway.” What rationale might you use to support your position?
Discussion Guidelines: Students should recognize that the vestibule and the external genitalia contain perineal flora. Care must be taken not to introduce flora into an incision or the urethra.
Assessments
Chapter 23: Gynecological and Obstetrical Surgery
ASSESSMENTS BY OBJECTIVE
| 1-5 | Workbook • Chapter 23 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 23 – Graded quizzes (Mastery Levels 1, 2, and 3) |
