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Basic Standard Procedure of Abdominal Hysterectomy: Part 1
1Department of Obstetrics and Gynecology, Okayama City General Medical Center, Kita-Ku, Okayama, Japan.
Surgery Journal (New York, N.Y.)
|June 13, 2019
Summary
Total abdominal hysterectomy (TAH) is a fundamental gynecological surgery. Mastering TAH involves careful dissection to avoid complications like ureteral injury, emphasizing sequential cutting and precise layer separation.
Area of Science:
- Gynecologic Surgery
- Surgical Education
Background:
- Total abdominal hysterectomy (TAH), or extrafascial hysterectomy, is a core surgical procedure for gynecologists.
- Potential complications include ureteral, intestinal, and bladder injuries, necessitating meticulous surgical technique.
Purpose of the Study:
- To explain the fundamental surgical procedure of Total Abdominal Hysterectomy (TAH).
- To detail a method for avoiding operative complications during TAH.
Main Methods:
- Sequential transection of ligaments, moving the ureter away from the cervix.
- Dissection of parametrial tissue along the cervical circumference in three distinct steps.
- Specific steps include clamping and cutting the uterine artery, sacrouterine ligament, and vesicouterine ligament with associated cardinal ligament portions.
Main Results:
- The described method aims to prevent ureteral, intestinal, and bladder injuries during TAH.
- Ensuring the uterus is "naturally removed" is a key principle for avoiding operative complications.
Conclusions:
- Adherence to a correct release layer procedure is crucial for safe TAH.
- The authors' two-point method provides a structured approach to minimize surgical risks in TAH.
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