Laparoscopic Hysterectomy with Removal of Ovaries - Part 3 of 4

Part 3 of a narrated, full-length total laparoscopic hysterectomy and removal of both ovaries for fibroids and pelvic pain. A Ligasure device is used to seal the vessels. Laparoscopic suturing is performed to close the vaginal apex after the uterus and cervix are removed. The entire procedure took approximately 35 minutes and is shown in its entirety in Parts 1 - 4. The patient went home right after surgery and can return to work in about 2 weeks.

Category:

Education

Tags:

• laparoscopic
• hysterectomy
• oophorectomy
• minimally
• invasive.
• TLH
• BSO
• pelvic
• anatomy
• laparoscopy
• surgery

[drchinmay81]

is this a monopolar hook which you r using for cutting around vault... is harmonic more advisable for this sir?

[DrKevinStepp]

@drchinmay81 - I use monopolar hook on pure cutting current. I don't think there is any data that one technology is better than another for the colpotomy. The most important issue is to not damage the tissue excessively. That can happen to matter what energy source you use. Harmonic makes a bit less smoke, but gets very hot. Be careful while you are learning. Good luck.

[gynedoc]

Dr Strepp, Can you advise what diathermy settings you use for the monopolar hook?

Many thanks

[DrKevinStepp]

@gynedoc -- I usually start at 45 watts pure cutting (non-modulated) currrent. I don't use Coag (modulated) current for the colpotomy. I adjust the watts up or down as necessary to achieve the effect I need as each patient is different. If you have access to Covidien V-mode on their newer generators, that is nice... less smoke and more hemostatic.

[shane95670]

so 13 more days in the hospital and things seem to have settled down. although we still cant get her to eat any solid foods. is this common?

[DrKevinStepp]

@shane95670 Ugh! I'm sorry she is having such a rough time. Hang in there. It is so difficult to comment on her actual case because with cancer surgery each case can be so different.... then throw in the kidney transplant and it gets even more complicated. My advice: support her through this difficult time and focus on the future.

[chourtnii]

what is the blue thing?

[WarningFedz]

WTF IS THIS SHIT L0L? THIS SHIT IS DISQUSTING GF BITCHES BABIEZ DISLIKED NIGGY MAD?

[sugajarr]

hi Dr Kevin,

days before my period, i can feel a bump on my right ovary more visible when i am lying down. it disappears as soon as my period starts, is that normal? i also have high fever, shivering, lower back pain, wind, constipation and nausea. i'm 28 and African. my aunt died from ovarian cancer at 32 so i am always worried. thanks.

[dr777666777]

why didn´t you remove the ovaries along with the uterus in one piece, i mean to do the cutting through the infundivulopelvic ligament during the hysterectomy so you wouldn't have to go back to remove the ovaries after doing the histerectomy, i think that would save a little time

[DrKevinStepp]

@shane95670 Ugh! I'm sorry she is having such a rough time. Hang in there. It is so difficult to comment on her actual case because with cancer surgery each case can be so different.... then throw in the kidney transplant and it gets even more complicated. My advice: support her through this difficult time and focus on the future.