Uterus, Intraoperative

  1. Ink anterior surface blue, and posterior black.
  2. Open through the cervical os and extend along the lateral walls of cervix and corpus.
  3. Carefully inspect the endometrium for masses, measure size, and describe appearance.
  4. Inspect the lower uterine segment, cervix, and adnexa (if present) for lesions.
  5. Make 1 cm thick transverse sections through the entire endomyometrium.
  6. Measure depth of invasion, if present, and freeze this section (may have to bisect and use 2 blocks).
  7. If no gross tumor is identified, palpate the myometrium to ensure a thickened/abnormal wall is not present (endophytic tumors may not be grossly visible, but are noticeable upon palpation). If present, freeze a representative section.
  8. If no tumor is grossly visible or palpable, discuss findings with surgeon.
  9. When reporting results to surgeon, be sure to include size, depth of invasion (<50% or >50%), tumor type, and grade (if applicable), as these criteria are necessary to dictate further management.
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