PFD Week 2016-Overcoming Challenges to The Difficult Vaginal Hysterectomy

Overcoming Challenges to The Difficult Vaginal Hysterectomy

Video Transcription

Video Summary

This video provides insights and techniques to overcome challenges in performing vaginal hysterectomy. The key principles include achieving adequate exposure, sharp dissection, delay of entry into the anterior cul-de-sac, securing vascular pedicles in a limited space, morcellation of large uteri, round ligament technique for removal of high adnexa, and detection of urinary tract injury. The use of a self-retaining retractor, specifically the Magrina Bookwalter vaginal retractor system, is recommended for better exposure. The video also explains methods for dissecting the anterior and posterior cul-de-sacs, ligating pedicles using a vessel sealing device, morcellation techniques for large uteri, and the round ligament technique for removing ovaries. The importance of cystoscopy after vaginal hysterectomy is also highlighted to diagnose and repair urinary tract injuries.

Asset Subtitle

Jennifer Klauschie, MD

Keywords

vaginal hysterectomy

exposure

sharp dissection

morcellation

urinary tract injury