Hemostasis

Process developed to prevent blood loss when vessel is

injured
Steps in hemostasis
Vascular phase
Platelet phase
Coagulation phase
Fibrosis and fibrinolysis
Vascular phase
Contriction of vessel starts immediately after injury

Local
Myogenic Nerve
autacoid
reflexes reflexes
factor
Platelete phase
Platelete aggregation forms a plug before blood cloth
Formed by fragmentation of large megakaryocytes
Lacking ability to devide

Platelete
Platelete swelling and
Vessel
attach to the stick by
compromise
torn thromboxane
A2
Clotting phase

Process
Fibrin Retract and
mediated by
reinforce the pull the edge
coagulation
platelete plug of torn vessel
factors
Coagulation
Fibrinolysis
Once clot forms, the vesel wall will heal
The clot may dissolve or form fibrous tissue
BIOLOGI HEMOSTASIS
Marsupialization of bartholin
Background
The greater vestibular gland for secreting mucus
Contains of a duct 5 mm diameter, gland 1,5-2 cm
Oval, inferior and lateral to bulbocavernosus muscle.
Innervation is received from branch of perineal nerve
Artery and venous from bulbocavernosus muscle.
Anatomy
Patophysiology

Obstruction Bartholine
Infection
of the duct cyst
Patophysiology
Bartholine cyst
Treatment
Antibiotics
Word catheter placement
Gland excision
Marsupialization
Word Catheter

Word catheter to drainage

bartholin cyst
Word Catheter

Word catheter to drainage

bartholin cyst
Gland excision
Gland excision
Gland excision
Gland excision
Gland excision
Gland excision
Gland excision
Marsupialization
Indication:
History of recurrent bartholin gland cyst
Significant patient pain
Failure of expectant management
Patient decline word catheter
Contraindication
Patient refusal
Technical consideration
Is the procedure must be perform in the operating
room?
Cyst or abscess
If abscess, what are the microorganism/ are they
treated adequatly
Is the patient immunocompromise
Are they comorbidities will ccause healing problem
Technique
Bimanual examination
Retraction of labia
Make 1,5-2 cm vertical incision
Incised the wall and gland, and evacuate cyst content
Suture the walls of the cyst to the vaginal mucosa
medially and introitus laterally
Clifford R. Wheeless, Jr., M.D. and Marcella L.
Roenneburg, M.D. Atlas Of Pelvic Surgery 2008
Clifford R. Wheeless, Jr., M.D. and Marcella L.
Roenneburg, M.D. Atlas Of Pelvic Surgery 2008
Clifford R. Wheeless, Jr., M.D. and Marcella L.
Roenneburg, M.D. Atlas Of Pelvic Surgery 2008
THANK YOU