How to manage granulation tissue at the stump after total hysterectomy
Dec 30, 2022
Source: Cainiu Health
Dr. Lv Aiming
Introduction
Granulation tissue at the residual end after total hysterectomy may result from inflammatory stimulation causing hyperplasia at the stump. This can be treated surgically by excision. First, the patient cleanses the external genitalia, assumes the lithotomy position, and spreads her legs to expose the vulva. The physician then inserts a vaginal speculum to open the vagina, carefully observing the relationship between the polyp's base and the surrounding tissues. Using a loop electrode, the polyp is encircled at its distal stalk and excised at the base.
After a total hysterectomy, granulation tissue at the residual end may result from inflammatory stimulation and subsequent proliferation at the stump. This can be managed surgically by excision, with the specific procedure as follows:
1. First, clean the patient's external genitalia and lay sterile drapes on the operating table.
2. Position the patient in the lithotomy position, with legs spread to expose the external genitalia.
3. The physician then inserts a vaginal speculum to open the vagina, disinfects the vaginal walls and the cervical area, and clearly observes the morphology, size, and pedicle location of the granulation tissue under direct vision. The relationship between the base of the polyp and surrounding tissues should be carefully assessed to plan the cutting technique.
4. To remove the polyp, use a loop electrode to encircle the distal portion of the polyp's stalk and cut through it. The depth of the electrosurgical resection should extend approximately 2–3 mm into the underlying superficial muscular layer beneath the stalk.
5. After removal, withdraw the vaginal speculum and loop electrode sequentially from the vagina. Maintain proper perineal hygiene and observe the patient in hospital for several days.
