Dissecting and Identifying the Ureter and Uterine Arteries is Necessary at the Laparoscopic Hsterectomy / 中国医师杂志

ABSTRACT

Objective To search for the technique of increased safety and diminished blood loss through laparoscopic hysterectomy. Methods A technique for dissecting the pelvic retroperitoneum and identifying the ureters and uterine arteries was used in the right pelvic side wall. The left side was used a non-anatomical approach. Visualization of the right ureter necessitate opening the peritoneum of the right pelvic side wall. A technique of identification and dissection the right ureter and the uterine vessels retroperitoneal at the initiation of laparoscopic hysterectomy was used. First, the obliterated hypogastric arteries were identified retroperitoneally. Second,the paravesical and the pararectal spaces are developed. Finally, the ureter and the uterine vessels were easily identified from the pararectal space. Once the retroperitoneal dissection had been completed and vital structures identified, hysterectomy be carried out. Results WT Fifty patients underwent this procedure. Right pelvic side wall versus left mean operation time was 33 min versus 22 min, and the mean blood loss was 12 versus 30 ml. It took 21 min on average to identify the right ureter and the uterine vessels retroperitoneal. Conclusion Identification and dissection of the ureter and the uterine vessels retroperitoneal is an acquired skill. This technique increases safety and diminishes blood loss. The uterine arteries and the uterosacral ligament are confidently desiccated once the path of the ureter near is identified. A non-anatomical approach to laparoscopic hysterectomy may be easier to learn, but it is neither very versatile nor safe.