How do you minimize common risks in total vaginal hysterectomy?

A total vaginal hysterectomy (TVH) can alleviate a patient of the discomfort and symptoms of a genital prolapse, benign dysfunctional bleeding or small fibroids.  What are the risks and how can they be minimised?

A total vaginal hysterectomy (TVH) can alleviate a patient of the discomfort and symptoms of a genital prolapse, benign dysfunctional bleeding or small fibroids.  What are the risks and how can they be minimised?
Review our new Total Vaginal Hysterectomy procedure now available on the Touch Surgery app to learn how our gynaecology key opinion leader Dr. Pasic describes how to safely perform this procedure.

Key facts:

  • The TVH procedure is a minimally-invasive surgery, resulting in faster recovery and return to normal activity for the patient.
  • The American College of Obstetrics and Gynecology (ACOG) recommend the use of this procedure as the first mode of choice for the removal of the uterus due to its advantages over alternative methods.

“The surgeon should look for bladder and vaginal ruggae…”  says Dr. Pasic who stresses the importance of using a self-retaining retractor such as the Magrina-Bookwalter to improve access to, and visualization of, the surgical site.  

“The surgeon should look for bladder and vaginal rugae as this helps to determine the position of the bladder in reference to the cervix.”  –Dr. Paya Pasic (University of Louisville)

 


Magrina-Bookwalter retractor: improved access and visualization reduces risk
Avoid inadvertent rectal damage

Damage to the rectum can be minimized during the posterior dissection and entry to the peritoneum by using a careful and precise approach:

“The incision should be done with a single cut.  The scissors should be placed parallel to the plane of the cervix to avoid inadvertent rectal injury.”

Learn how Dr Pasic uses the Ethicon ENSEAL® X1 Device to reduce the risk of ureter damage when transecting the uterosacral ligaments.  This device reduces thermal spread and risk of damage to surrounding tissues when cutting.
The ENSEAL® X1 Device should be placed across and rotated around the ligament so that the tips of the blades stay within the cervix circumferential incision.” -Dr. Paya Pasic (University of Louisville)

Try our new simulation – The Total Vaginal Hysterectomy – on the Touch Surgery App and test your procedural awareness.