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Biomedical subjects

P Kamina

Publications and source records attributed to P Kamina.

30 records · Page 2Linked to original sources
PubMedDate not supplied

[From the anatomy to the technic of vaginal hysterectomy].

The technical difficulties in the vaginal hysterectomy (VH) are principally raised by the special conceptualization of the normal anatomy in the craniocaudal direction and the topographical modifications from the surgical manipulations. These modifications have been studied during an operative dissection on a dead body non-formulated, but with the vessels previously injected with coloured latex. Our observation and the numerous works of per-operative radiology are showing that, at every period of the VH there is an ureterical safety margin much more important than in the abdominal hysterectomy. The prime manipulation in its realization is the caudal and continuous traction of the cervix in order to individualize the ligaments and to make easier the dissections. The operation amounts to three primary stages: breaking away the uterus from its visceral connections in order to hold them distant with valves; releasing the uterus from its ligaments with ligatures spaced from the cervix to the fundus; restituating the peritoneal cavity and the vaginal fornix in its topography and statics. The vaginal hysterectomy has notable advantages in swiftness, absence of intestinal manipulations and scarceness of ureterical injuries. The anatomical limits in the low way, depend on the vaginal compliance, the mobility of the pelvic organs and the disproportion between the vagina and the deferent duct.

Cervix Uteri↗
PubMedDate not supplied

[Functional anatomy of the pelvic veins in women].

Pelvic veins and lower extremities veins form a functional unit resulting in the interaction of their pathology. The intrapelvic venous system consists of two independent networks, under physiological conditions: the parietal and the visceral networks. The main collectors are the internal iliac veins, the ovarian superior rectal veins. The original venous plexi, located in the sub-peritoneal pelvic connective tissue, remain open because of the adhesion of their wall to the parietal pelvic fascia. The parietal venous network, abundant and supplied with valves, includes the retro-public and sacral plexi. The usual venous drainage is encouraged by abundant anastomoses, the decrease or even the absence of valves and the abdominal pressure. When this pressure increases, especially during walking, this encourages pelvic drainage. Occasional venous drainage is observed in case of obstruction of the usual collectors. Anatomical obstacles to the drainage, besides thrombosis and tumors, are essentially: compression of the left common iliac vein by the right common iliac artery, and direct compression of the inferior vena cava by the uterus during pregnancy which compresses it against the spine. It is responsible for gravidic postural shock, and an increased abdominal pressure, exceeding 20 mmHg. The main supply pathways are the ovarian veins and the vertebral plexi. This large, low-pressure avalvular plexus may function easily in both directions caudo-cranial and cranio-caudal. The relationship of this plexus with the roots of the sciatic nerve explain certain sciaticas during pregnancy. Dilatation of the ovarian veins during pregnancy cause a so called syndrome of the ovarian vein. Various venous compressions during pregnancy are responsible for some hematurias, increased collateral abdominal circulation, and turgescent haemorrhoids and vulvar varicose veins.

Abdomen↗
PubMedDate not supplied

[Fossae, recesses and culs-de-sac in the pelvic peritoneum of women (author's transl)].

The pelvic peritoneum in women is peculiarly irregular because of the numerous folds, fossae, recesses and culs-de-sac that exist in it. Blood and purulent serous fluids occur in the abdomino-pelvic cavity and stagnate in these sites. Since they are particularly to be found around the adnexae they can give rise to secondary infection occurring as a result of primary adnexal infection. Furthermore, when serous fluid is regurgitated into the tubo-ovarian hollow through the abdominal os of the tube and into the pertoneum around the ovary, adhesions and endometrial deposits occurring in this area can be explained. Each one of these structures should be systematically explored, particularly when hystero-salpingographies and laparoscopies are being carried out. Furthermore, they should be cleaned out very meticulously after all conservative surgery to prevent the formation of adhesions.

Adult↗