You are at the pelvic sidewall, the ureter somewhere beneath the uterine artery, the field distorted by tumor and prior radiation, and the next move cannot wait.Misjudge that junction and the cost arrives later - the ureteral injury recognized two weeks too late as a fistula, the suboptimal debulking that adds morbidity without survival, the occult cancer scattered by a morcellator.This handbook names every committing decision in gynecologic oncology surgery - the threshold that governs it, the hazard hidden in it, and the one anchor that locks the correct call - so you reason through each operation before you reach it.- The Operative Decision-Point System - walk into every case having rehearsed its committing junctions, from cervical biopsy to total exenteration- Recognize injury before you close - confirm ureteral integrity by jets and near-infrared imaging instead of discovering a fistula on day fourteen- Calibrate radicality, not reflex - match the Querleu-Morrow type to the tumor and spare the bladder branch when disease allows- Operate or de-escalate - apply SHAPE, sentinel mapping, and the LACC evidence to do less safely and operate open when open saves lives- Drive cytoreduction to zero residual - judge resectability before you commit- Read the unresectable pelvis early - catch the triad and porta hepatis before a heroic operation turns futile- Fill the empty pelvis - prevent fistula and obstruction the irradiated field invites- The Operative Decision-Point Atlas - scan every decision, indexed by procedure, danger zone, and complicationWritten for gynecologic oncology fellows, practicing gynecologic oncologists, Ob/Gyn residents, surgical trainees, and the advanced practice providers beside them.Open it before your next case, and decide with the clarity every patient on the table deserves.
AmazonPagina's: 211, Paperback, Independently published
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