In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman is joined by MIGS specialist Dr. Uchenna Acholonu to discuss the intricacies of complex gynecologic surgeries, focusing particularly on handling large uteruses during total laparoscopic hysterectomy (TLH).

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SYNPOSIS

The discussion begins with talk of the doctors’ practices and friendship. They then cover comprehensive patient evaluations and various surgical techniques, including skeletonizing the uterines, colpotomy tricks, uterine manipulators, and morcellation. Dr. Acholonu also shares his personal routines and preferences, including the use of a flexible scope to get around the big uterus. The duo exchange insights on surgical techniques, patient-centered care, and the continuous learning necessary in the medical field. They emphasize the significance of safety, adequate planning, and the benefits of engaging in community networks for better surgical outcomes. The conversation concludes with a light-hearted note on their shared experiences and camaraderie, offering both educational value and a glimpse into the dynamic relationship between two seasoned professionals.

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TIMESTAMPS

00:00 - Introduction

04:01 - Building a Subspecialty Practice

07:34 - Patient Referrals

12:41 - Surgical Approach

16:06- The Big Uterus

28:36 - Surgical Steps in TLH, Skeletonizing the Uterines

32:56 - Challenges and Solutions

36:49 - Energy Sources and Surgical Tools

42:34 - Colpotomy

44:43 - Tissue Extraction and Morcellation

50:27 - Closing and Post-Operative Care

52:05 - Use of Lupron

53:16 - Final Thoughts