Photographic documentation of these anatomic regions would provide an additional advantage. We recommend a minimum of 6 photographs until of the 6 pelvic zones in the absence of pelvic pathology. These six zones are depicted in Figure 1. Images of these zones will supplement the report. In addition, if surgeons dictate according to the zones, comprehensive details will be incorporated into the description report. Two copies of photos should be available for charting. In summary, a comprehensive description of important pelvic structures is frequently missing in operative notes from diagnostic and operative laparoscopy. The anterior cul-de-sac, deep inguinal rings, and the lateral pelvic sidewall peritoneum are the most frequently missed areas. A large proportion of gynecological surgery utilizes operative and diagnostic laparoscopy.
Intraoperative photographic documentation is a true benefit to this approach. Lack of a standardized protocol for photographic documentation is a missed opportunity in providing quality patient care. The advantages of our proposed system are several. First, it is based on anatomical landmarks, which allow standardization. Second, it is comprehensive as it includes all pelvic major structures such as the bladder, uterus, adnexa, and the rectosigmoid colon. It also covers supportive pelvic structures such as the round ligaments, the broad ligament, and the uterosacral ligament. Moreover, it describes peritoneal surfaces such as the anterior and the posterior cul-de-sac and the ovarian fossa.
In addition, it covers frequently missed areas such as the internal rings and the triangular peritoneal area lateral to the fallopian tube and the infundibulopelvic ligament. Lastly, it is easy to follow system whereas the examination could be performed in anteroposterior, then lateral fashion where zone I and II will be examined first (midline zones). Subsequently, lateral zones (right zones III and IV followed by left zones III and IV) are to follow. Alternatively, clockwise or counterclockwise examination could be performed. The main limitation of this study was the retrospective use of sources to validate the use of our novel system. In the future, we plan to use operative reports that include photography in order to prospectively describe the six pelvic zones in order to validate this method.
By doing this, we propose that more pathology will be diagnosed resulting Cilengitide in improved patient care and communication between surgeons will be improved by extension. Conflict of interests The authors report no conflict of interests.
The existence and the localization of specific cognitive functions of cortical areas such as movement, speech, or vision were of great importance for the pioneers of neurosurgery to omit severe postoperative side effects such as hemiparesis or aphasia in the mid 19th century.