title: A laparoscopic bipolar cutting forceps can assist in a case of difficult vaginal hysterectomy.
abstract: A vaginal approach to hysterectomy can become challenging when visualization is limited by poor or absent uterine descent, obesity, or other factors that make an approach to the uterine pedicles difficult. When factors occur that make application or visualization of conventional vaginal instruments difficult, using an instrument designed for laparoscopic application, with its thin, elongated shape, may permit continuation of a vaginal approach. In such a case, a Gyrus bipolar laparoscopic cutting forceps was used for coagulation and transection of the uterine pedicles during a vaginal hysterectomy. This represents a way to expand on traditional techniques for completion of difficult vaginal hysterectomy, which may be used concurrently. Surgical techniques that more easily and safely permit completion of hysterectomy by the vaginal approach can improve outcomes for all.
authors.affiliation: Department of Obstetrics and Gynecology, Summa Health System, Akron, OH 44303-2090, USA. fentonb@summa-health.org
authors.forename: Bradford W
authors.initials: BW
authors.lastname: Fenton
authors.forename: Tim
authors.initials: T
authors.lastname: Hutchings
authors.forename: Robert F
authors.initials: RF
authors.lastname: Flora
authors.forename: James
authors.initials: J
authors.lastname: Fanning
mesh_terms: D001158:Arteries; D000075202:Contraindications; D004867:Equipment Design; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000295:instrumentation* / Q000379:methods; D010535:Laparoscopy; D008026:Ligation; D013525:Surgical Instruments; D014599:Uterus / Q000098:blood supply