A new technique and system for simplifying total laparoscopic hysterectomy

Area of Science:

• Minimally Invasive Gynecological Surgery
• Surgical Instrumentation and Techniques

Background:

• Total laparoscopic hysterectomy (TLH) is technically demanding, leading to frequent use of laparoscopic-assisted vaginal hysterectomy.
• This often results in suboptimal outcomes for patients where TLH might be more appropriate.

Purpose of the Study:

• To present a novel technique and instrumentation designed to simplify Total Laparoscopic Hysterectomy (TLH).
• To increase the success rate and adoption of TLH by gynecologists.

Main Methods:

• Development of a surgical system combining a pneumo-occluder, a palpable and visible cup, and a uterine manipulator.
• The cup is used to delineate vaginal fornices, guiding safe dissection and preventing ureteral injury.

Main Results:

• The described technique and instrumentation facilitate safer and more efficient execution of TLH.
• The system allows for acceptable operating times, enabling TLH to be combined with other gynecological procedures.

Conclusions:

• This innovative system aims to overcome the technical challenges associated with TLH.
• Increased performance of TLH is anticipated, potentially leading to improved surgical outcomes in gynecological procedures.