Cautery of round ligament |
Lysis of left adnexal adhesions |
Anterior left round, open bladder flap |
Left bladder flap |
Bipolar cautery |
Puncture peritoneum, left infundibulo-pelvicligament ligament |
North-south move, left adnexa |
Pass tie, left infundibulo-pelvic ligament |
Pulley maneuver |
Placement of surgeons throw |
Second throw, followed by a third and fourth |
Divide pedicle |
Loop pedicle |
Posterior broad ligament incision |
Vessels coagulated, bipolar scissors |
Anterior broad ligament incision, bladder flap |
Bladder flap dissection |
Second layer, bladder flap |
Right broad ligament, utero-ovarian ligament |
Skeletonization of right uterine vessels |
Cauterization of uterine vascular pedicle with Kleppinger forceps |
Endoloop |
Clamping of pedicle |
Application again of Kleppinger forceps to pedicle |
Bipolar scissors divide pedicle |
Kleppinger forceps applied again |
Endoloop around pedicle |
Process repeated, clamp too lateral, then properly placed at cephalad |
Cutting of pedicle |
Kleppinger forceps applied below left pedicle |
Endoloop again around pedicle |
Endoloop tightened, clamp released |
Kleppinger of vaginal angles |
Monopolar incision of vaginal cuff |
Cauterization of uterosacral ligament |
Cauterization of posterior vaginal cuff tissue |
Monopolar needle incision of left vaginal apex |
Uterus and cervix are freed |
Pulling uterus out |
Examination of vascular pedicles, cut peritoneal edges, and vaginal
cuff |
Laparoscopy in Urogynecology and Reconstructive Pelvic Surgery |
Introduction to Hasson Method |
Modifications to Original Techniques |
Application of Uterine Elevator |
Skin Incision and Grasping of Fascia |
Dissection and Visual Abdominal Entry |
Procedures for Creating an Airtight Seal and for Closing the Incision |
Step-By-Step Review of Technique |