Cervical Conization (Cold Knife)

Chapter 234 Cervical Conization (Cold Knife)



DESCRIPTION


Cervical conization is a diagnostic or therapeutic procedure that removes a cone-shaped specimen from the uterine cervix. Cold knife cone biopsy used to be the preferred treatment for removing abnormal cells, but now most cone biopsies are performed using wire loop and electrosurgical energy (loop electrosurgical excision procedure [LEEP]/large loop excision of the transformation zone [LLETZ] cone). Cold knife cone biopsy is generally used for special situations, such as when the size or shape of the specimen must be customized to a greater degree than allowed by loop procedures.



INDICATIONS


Histologically verified advanced epithelial atypia (for diagnosis or therapy) or inability to adequately evaluate the cervix through colposcopy.



CONTRAINDICATIONS


Coagulopathy, advanced pregnancy, known or suspected allergy to the agents used.



REQUIRED EQUIPMENT



• Skin (vaginal) preparation materials (iodine-based antibacterial solution [e.g., Betadine] or other suitable cleansing agents)

• Sterile gloves

• 0 or 2-0 synthetic absorbable suture on a medium needle

• Needle holder, long thumb forceps, suture scissors

• Retractors (two Deaver or right-angle retractors and/or weighted speculum)

• Scalpel (#11 blade)

• Uterine sound (blunt probe) or small cervical dilator

• Sponge stick (may be useful to atraumatically grasp and manipulate the cervix)

• Electrosurgical generator, hand piece, and return electrode (“ground pad”)

• Monsel’s solution or paste (ferric subsulfate)

• Histology fixative (10% formalin) in containers

• 5% acetic acid or Lugol solution (super-saturated potassium iodide) if colposcopy is to be performed

• Vaginal Pack (optional)


TECHNIQUE

Related posts:

  1. Anemia
  2. Toxic Shock Syndrome
  3. Uterine Anomalies: Bicornuate, Septate, and Unicornuate Uterus
  4. Cervical Cancer

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Cervical Conization (Cold Knife)

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