• A Foley catheter is placed.
  • Abdominal wall incision is made, layers of the abdomen are identified and opened, and after the incision is made self-retaining retractors are placed.
  • The mesosalpinx (if the ovary is retained) or infundibulopelvic ligament (if the ovary is being removed) is clamped coagulated and cut.
  • With successive clamping, coagulating, and cutting, the dissection continues down the broad ligament to the uterine vessels.
  • The anterior bladder peritoneum is incised with scissors and the bladder is pushed down with the sponge stick forceps. Broad ligament is pushed forward with the surgeons’ fingers.
  • Placing right angle hysterectomy clamps, the cervical vaginal junction is incised and the uterus and cervix are removed.
  • Grasping the anterior vaginal mucosa place your first bite with a barbed suture such as 2-0 Stratifix Knotless Tissue Control Device
  • Place Suture on the uterosacral ligament incorporate this as your second closure bite.
  • Suture the posterior angle to complete the angle closure (Only the angles have three bites for closure).
  • Run the suture anteriorly to posteriorly, making sure full-thickness bites are taken, to the opposite angle. 
  • Lastly, complete the angle in a similar manner as previously mentioned (3 bites).
  • Back track the suture one or two bites then cut the remaining suture. 

Note: Vaginal cuff can be closed using 0-Vicryl Plus suture in a continuous or interrupted technique.

  • Skin staples are used for skin closure.