TAH

Step 2

Bladder flap is cut by grasping the peritoneum of the vesicouterine fold just below the reflection onto the uterus

Step 4

Th infundibulopelvic ligaments (ovarian a. and v.) are isolated form the ureter and triply clamped. Vessels are doubly ligated with the tissue below the clamp being suture-ligated

Step 5

Uterine vessels are skeletonized, 3 clamps are placed (first one closest to the uterus). Uterine vesseles are cut and then doubly suture-ligated with 0 Vicryl, with care to pass needle right beneath the tip of the clamp.

Step 7

Uterosacral ligaments on either side are clamped, cut, and suture-ligated. Stay as close to uterus as possible to avoid uteters.

Step 6

Cardinal ligaments are clamped in juxtaposition to the uterus, avoid infringement of the ureter, which is close to the uterine cervical junction. Ligaments are sutured with 0 Vicryl, with transfixion stitch

Step 1

Round ligaments are clamped, divided, and suture ligated with 0 Vicryl

Step 3

Sponge forceps, the bladder is pushed inferiorly from the cervix. Stay midline pushing onto the cervix