Hysterectomy with an incision in the back wall of the vagina

Hysterectomy for the posterior wall of the vagina is used for the surgical treatment of uterine fibroids. When uterine fibroids are large, or cervical multiple myomas, or uterine fibroids with uterine body fibroids, the adjacent organs are often ectopic. When hysterectomy is performed, it often causes difficulty in surgery and is difficult to perform in a conventional manner. It is often necessary to change the surgical procedure. Treatment of diseases: uterine fibroids Indication When the anterior wall of the uterus is stuck, the boundary is unclear, the bladder is difficult to push down or the anterior wall of the vagina is unclear, the posterior wall of the vagina can be cut open for hysterectomy. Contraindications 1. Serious adhesion of the rectal fossa. 2. Acute pelvic inflammation. Preoperative preparation Intestinal disinfectant, cleansing enema, other abdominal hysterectomy. Surgical procedure 1. From the beginning of surgery, the treatment of round ligament, pelvic funnel ligament, uterine blood vessels and total hysterectomy, cut the bladder peritoneal reflex, when pushing down the bladder, should be carefully identified, light separation, not too low. 2. Clamp, cut, and suture the bilateral uterine fibular ligaments, cut the peritoneum, push the rectum, expose the uterus and rectum, and remove the whole hysterectomy. 3. The method of clamping, cutting, and suturing the bilateral main ligaments is the same as before. At this time, special attention should be paid to the bladder, and the clamp should not be too deep. 4. Cut the posterior wall of the vagina as far as possible to pull the uterus to the premise, reveal a wider vaginal posterior wall, cross the small mouth at the proximal iliac crest, make sure to enter the vagina, extend into the scissors and wrap the vaginal wall forward, as close as possible to the top of the iliac crest. When you reach the front wall, you can cut it under direct vision, or put your hand into the vagina and lift the front wall to cut it. Followed by hysterectomy. If the adhesion is severe, the uterine blood vessels and the main ligament may be treated after the vaginal wall is opened. 5. Other steps are the same as total hysterectomy.

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