A simplified surgical technique for the treatment of the vault in vaginal hysterectomy.
The surgical steps in the various techniques to remove the uterus by vaginal hysterectomy are quite uniform; however, the handling of the vaginal cuff differs with each and all techniques reviewed. The technique here described is a simplified method that secures hemostasis, establishes drainage of the anterior vaginal wall, and creates a vaginal canal adequate for sexual function. Emphasis is placed on the inclination of the vagina, a step that brings the vaginal axis almost perpendicular to the body axis, obviating the constant bearing-down effect on the intra-abdominal pressure on the apex of the vagina. Prevention of subsequent enterocele formation is achieved by the occlusion of the weak spot between the ulterosacral ligaments, the site of the hernial sac formation.
D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control