Vous êtes sur la page 1sur 15

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

1
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

2
Gynecology surgery

3
Objectives

Pre-operative preparation :
Laboratory
CXR
EKG, echocardiography
Imaging
BNO IVP
Blood preparation
ICU, Intermidiate care unit
Informed concent
4
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)

5
CHEST X RAY

Lung & Cardiac evaluation


Pleural effusion
Bronchopneumonia
Lung metastasis
Cardiomegaly

Spirometry restricton level

6
EKG, ECHOCARDIOGRAPHY

Simple cardiology evaluation

Echocardiography
Cardiac morphology
Cardiac functiom

7
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)

8
BNO IVP

Renal function

Risk of Urology tract injury


Ureter catheter
Double J stent catheter

9
BLOOD PREPARATION

Indication by estimation
PRC
WB
FFP

Risk of massive or serious beleeding


Long operation
Severe adhesion

10
ICU

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

ICU
HCU

11
IINFORMED CONCENT

Definive planning of surgery


procedure

Risk of Complication
Prognosis
Site of marking

12
ANTIBIOTIC

Prophilaxys antibiotic
Single dose
Narrow spectrum

May coniunued with empirical


antibioticsd

13
TAKE HOME MASAGES

Pre-operative preparation will improve


successfulness of surgery

Optimal preparation may minimize serious


unpredictable complication

14
Terima kasih

15