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Updated: Aug 17, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Total laparoscopic hysterectomy: a tried and tested technique
Nicholas Elkington1, Gregory Cario, David Rosen
1Sydney Women's Endosurgery Centre, St. George Private Hospital, Kogarah, Sydney, NSW, Australia. nickelkington@hotmail.com
Abstract:
Gynecologists are increasingly adopting total laparoscopic hysterectomy as their preferred method for performing a hysterectomy. The laparoscopic approach offers a superior view of the anatomy, facilitates meticulous hemostasis, enables the surgeon to perform adnexal surgery and pelvic reconstructive surgery, and reduces morbidity associated with large abdominal incisions. During the last 10 years, the surgeons at the Sydney Women's Endosurgery Centre (SWEC) have developed a laparoscopic technique using the same well-known steps as in the open abdominal approach. The ovarian pedicles are ligated, the uterine pedicles and vaginal vault are sutured laparoscopically, and some novel time-saving maneuvers are adopted.
