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Updated: Jun 10, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Gynecologic surgery and the management of hemorrhage
William H Parker1, Willis H Wagner
1Department of Obstetrics and Gynecology, Saint John's Health Center, University of California Los Angeles School of Medicine, 1450 Tenth Street, Santa Monica, Los Angeles, CA 90401, USA. wparker@ucla.edu
Abstract:
Surgical blood loss of more than 1000 mL or blood loss that requires a blood transfusion usually defines intraoperative hemorrhage. Intraoperative hemorrhage has been reported in 1% to 2% of hysterectomy studies. Preoperative evaluation of the patient can aid surgical planning to help prevent intraoperative hemorrhage or prepare for the management of hemorrhage, should it occur. To this effect, the medical and medication history and use of alternative medication must be gathered. This article discusses the methods of preoperative management of anemia, including use of iron, recombinant erythropoietin, and gonadotropin-releasing hormone agonists. The authors have also reviewed the methods of intraoperative and postoperative management of bleeding.
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