Description

Minimal Access Laparoscopic Hysterectomy is becoming a very common procedure, although significant concerns about the procedure voiced by many gynecologists are twofold: The ability to confidently close the vaginal cuff laparoscopically and the fear of cuff dehiscence and ureteric injury. This has resulted in many practitioners securing the uterine artery vaginally and closing the cuff vaginally, which increases operating time, or converting to LAVH or LSH. We have developed a nice desiccation technique of uterine artery during Total Laparoscopic Hysterectomy and vaginal cuff closure technique following TLH that incorporates the same surgical principles as closure for an abdominal hysterectomy. It is easy to learn and simple continuous suturing is required intracorporeally to close the vault. Mean surgical time is half an hour. This video demonstrates the use of a vessel sealing device to perform a laparoscopic hysterectomy with an obliterated posterior cul-de-sac. This technique demonstrates how to dissect the anterior compartment first. Then we controlled the large uterine vessels.