simple vulvectomy

This procedure is to remove all vulva, including partial vaginal, clitoris, large and small labia and partial perineal resection. Treatment of diseases: genital warts and vulvar cancer Indication 1. Multifocal vulvar carcinoma in situ. 2. Chronic vulvar dystrophy is ineffective by conservative treatment, especially proliferative malnutrition with biopsy. 3. A genital warts that are huge or involve the entire vulva and are difficult to cure with drugs or other methods. Surgical procedure 1. Position: The position of the stone. 2. Incision: The external incision is fusiform, on the upper part of the labia above the base of the clitoris, along the lateral side of the labia majora (1 to 2 cm from the outer edge of the lesion), to the perineal joint. The inner incision is also fusiform, starting from the ligament of the clitoris, the urethral opening, along the inner side of the left and right labia, and the outer edge of the vestibule, confluent to the labia. The incision line can be marked with a knife tip or gentian violet before the surgery begins. 3. Cut the skin and subcutaneous fat: cut the whole skin along the outer incision, from the pubic sputum, remove the pubic anterior skin, subcutaneous fat, the depth does not have to reach the fascia layer, cut to the pubic arch, the lower urethra Above, care should be taken to avoid damage to the urethra, and if necessary, a metal catheter can be inserted into the urethra indicating position. During the resection process, the clitoris, the veins and the clitoris feet are exposed, and the jaws should be clamped, cut, and ligated. The subcutaneous fat tissue is cut obliquely to the medial side of the labia majora, ending at the vaginal wall, and the depth does not have to reach the perineal fascia. Pay attention to the arteries and veins in the genital area. 4. Removal of the vulva: Cut the separated vulva tissue along the medial incision. 5. Stitching: suture the subcutaneous fat layer between the internal and external margins to eliminate the dead space. Then, the skin is intermittently sutured, and the urethral opening and the vaginal mucosa are respectively sutured to the surrounding skin, so that the wound is in the shape of a racket. The catheter was indwelled after surgery.