Yesterday we operated on 3 women with heavy menses. Our procedure was billed as a "simple" hysterectomy, but in fact was not "simple" at all. Our team consists of a gynecology attending, a urogynecology attending, a urogyn fellow, and a senior resident- a full gynecology force. We all insist , and believe that vaginal surgery is the best for the patient. We were determined to deliver fibroid and large uterus through tight vaginal openings with little exposure. Our first case the 2 attendings competed for the scalpel until one stepped back. There was instruction on entering posteriorly, clamping pedicles, and how and when to morcellate fibroids. After a long struggle fibroids and the uterus were delivered and the vault properly suspended. That was the first case.
With every case the movements became more coordinated, the case smoother, and Stephanie, our senoir resident, bolder. The most amazing part was that Stephanie's skill improved exponentionally throughout the day! By the last case she had morphed from a stay-in-the-back-quiet-Asian-girl to an I'm-an-amazing-vaginal-surgeon-don't-get-in-my-way. She was clamping faster than we could cut suture, directing us lowly assistants with direct clear orders, and morcelating fibroids with little effort. She had grown from a senoir resident with moderate confidence in the vagina to a master-vaginal-surgeon-in-training. With these cases, our patients were changed, we were changed, and we had all grown better.
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