Two-phase laparoendoscopic single-site cervical ligament-sparing hysterectomy: A novel approach in difficult laparoscopic hysterectomy

Abstract

Objective: To proposed a novel method for a difficult laparoscopic hysterectomy that spares the cervical ligaments and eliminates the cervical canal and transformation zone of the cervix. Case report: A 40-year-old women, gravida 3 para 3, who had had a cesarean delivery previously, was referred to the gynecology clinic due to adenomyosis with menorrhagia and severe anemia. Ultrasonography showed that the uterus was enlarged to 13.5 cm × 10.7 cm × 8.8 cm. After obtaining informed consent, a two-phase laparoendoscopic single-site (LESS) cervical ligaments-sparing hysterectomy was performed smoothly. The patient discharged on 4th day and resumed her sexual life less than 2 months after surgery. Conclusion: This novel minimal invasive method of hysterectomy makes difficulty laparoscopic hysterectomy easy and safe. Preservation of cervical ligaments retains stability in the pelvic floor and may reduce intraoperative complications and subsequent pelvic floor organ prolapse.

Keywords

• difficult laparoscopic hysterectomy
• laparoendoscopic single site surgery
• large uterus