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Vaginal hysterectomy

Uterovaginal prolapse or benign bleeding with a mobile, modest-sized uterus.

Source: Standard operative texts

Steps

  1. Lithotomy, catheter, Auvard speculum; vulsellum on cervix.
  2. Infiltrate dilute vasoconstrictor; circumferential incision round cervix.
  3. Push bladder up; open anterior pouch.
  4. Open posterior pouch of Douglas.
  5. Clamp–cut–transfix uterosacral & cardinal ligaments (keep ties long).
  6. Clamp–cut–tie uterine vessels.
  7. Clamp utero-ovarian pedicles & round ligament; deliver uterus.
  8. Check haemostasis; close peritoneum.
  9. Support vault — McCall culdoplasty / uterosacrals to vault.
  10. Close vault; pack and catheter per unit.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.