Extracorporeal Total Abdominal Hysterectomy

This procedure has been developed by Edouard Servy, M.D. and Robert Kaufmann, M.D. at Augusta Reproductive Biology Associates, Inc. in Augusta Georgia as an alternative to laproscopic, vaginal and traditional abdominal hysterectomies. Its benefits include 　 a smaller scar, less post-operative meds and shorter OR, hospitalization, and recuperative time than the traditional, large incision abdominal hysterectomy 　 shorter OR time and better visualization than laproscopic 　 better visualization and vaginal cuff colpoplexy than vaginal hysterectomies. 1 Exteriorization, tagging and section of round ligaments. 2 Exteriorization and evaluation of adnexa. Opening of broad ligaments. Clamping, section, suture of adnexal and cornual pedicles. 3 Pulling of uterine body with a tenaculum, then Kelly clamps, squeezing it through the skin incision. 4 Development of bladder flap with upward and backward traction of the uterus. 5 Clamping, ligation and section of cardinal ligaments. 6 Tagging and section of utero-sacral ligaments with upward, forward and lateral traction of the uterus. 7 Lateral opening with immediate closing of the vaginal cuff. Lateral traction maintained to keep cuff at or near skin level. 8 Utero-sacral ligaments approximation and cul-de-sac plication. 9 Attachment of round ligament pedicles to vaginal cuff to provide colpopexy. 10 Reperitonealization with bladder flap