Step-by-step colpotomy in total laparoscopic hysterectomy: a technique to avoid apical support damage to the upper vagina
Journal Title: UNKNOWN - Year 2019, Vol 20, Issue 2
Abstract
The purpose of this video article is to demonstrate our colpotomy technique that enables maximal protection of the cervical ring, helps to prevent the ureteral injury by distancing, and avoids shortening of the vagina at total laparoscopic hysterectomy. Step-by-step explanation of the colpotomy technique is presented using educational video setting in university-affiliated private hospital. After the uterine artery transection, a VECTEC surgical uterine manipulator (VECTEC, Hauterive, France) was inserted into the vagina in place of the sharp curette. The plastic rotating blade of uterine manipulator was strongly pushed forward into the anterior vaginal fornix. Colpotomy incision was started from the uppermost middle point of an anterior vagina, and extended to both sides with a monopolar L-hook electrocautery at 40 watts cutting mode. Then the manipulator’s blade was maneuvered into the right lateral fornix, and THUNDERBEAT platform (Olympus Medical Systems Corp, Tokyo, Japan) was chosen as the modality of energy for the transection of the rest of the vagina. At the posterior part of colpotomy, the vaginal wall was cut from the uppermost part of uterosacral ligaments, as well. Finally, the left lateral fornix was cut by the same principles, and colpotomy was completed circumferentially. In conclusion, maximal preservation of paracervical ligaments with this technique preserve the apical support of vagina, and avoids shortening of vaginal length. The technique also minimizes the ureteral injury by distancing.
Authors and Affiliations
Selim Mısırlıoğlu, Tonguç Arslan, Bülent Urman, Cağatay Taşkıran
Keywords
Related Articles
- EP ID EP582064
- DOI 10.4274/jtgga.galenos.2019.2018.0123
- Views 64
- Downloads 0
Do pregnancy rates differ with intra-uterine insemination when different combinations of semen analysis parameters are abnormal?
Objective: To evaluate the relationship of one or a combination of semen analysis parameter results on insemination outcomes. Material and Methods: A retrospective analysis was performed to evaluate the effect on pregnan...
Erratum
DOI: 10.4274/jtgga.2017.0115 Kurdoğlu Z, Carr D, Harmouche J, Ünlü S, Kılıç GS. Short-term results of the efficacy of percutaneous tibial nerve stimulation on urinary symptoms and its financial cost. J Turk Ger Gynecol...
Editorial
.
Highlights and future directions from the European Gynecological Oncology Congress 2017
.
Decoding stillbirths using the Relevant Condition at Death classification: Study from the developing world
Objective: To determine the stillbirth rate in 2017 at Christian Medical College, a tertiary care perinatal center in South India, and to identify causes for the various stillbirths that occurred using the Relevant Condi...