Interventional procedure overview of vaginal transluminal endoscopic hysterectomy and adnexal surgery for benign gynaecological conditions

What the procedure involves

The vaginal transluminal endoscopic hysterectomy procedure is done in a similar way to a conventional vaginal hysterectomy but uses an endoscopic view and laparoscopic instruments. The patient is placed in the lithotomy position. Under general anaesthesia, a circular incision is made in the vagina (around the cervix). Following anterior/posterior colpotomy and transecting the sacro-uterine ligaments, a keyhole instrument port is then inserted to improve access and visibility. The abdominal cavity is accessed through the colpotomy and then insufflated. Laparoscopic instruments are inserted and the surgery is done in a Trendelenburg (head down) position. Then the uterus, fallopian tubes or ovaries are removed vaginally (depending on the procedure type). Then the instrument port is removed, the abdomen is deflated, and the vaginal incision is closed with absorbable sutures.