Which of these is FALSE for laparoscopic hysterectomy?
The umbilical site typically is used in patients without a previous history of surgery or intra-abdominal infection. In cases of previous surgery where there was a midline incision or a history of a pelvic-abdominal incision, an open laparoscopy (mini lap at umbilicus) is recommended or an alternate site can be chosen to introduce the primary cannula. The most impoant step when placing lateral pos is to avoid the inferior epigastric vessels, which are branches of the external iliac aery and vein. The retroperitoneal space is opened after ligation of utero-ovarian ligament and the ureter identified on the medial leaf of the broad ligament.
In case of a previous midline scar, a minilap incision may be taken at the umbilicus for primary canula
While placing lateral pos , inferior epigastric vessels are to be avoided
After opening retroperitoneal space, ureter is identified over medial leaf of broad ligament
In LAVH uterine vessels are ligated laparoscopically after skeletonisation
Operative Gynecology