Supracervical hysterectomy, cervicosacropexy with gyno-mesh, bilateral adnexectomy, and anterior colporrhaphy, laparoscopic

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  1. Positioning

    Positioning
    • positioned in lithotomy position
    • It is recommended to position both arms alongside the body (caution: use cotton wrapping when positioning with a cloth sling), or to position one arm on the assistant's side
    • The legs should be adjustable via the operating table controls
    • if necessary, use shoulder supports to prevent the patient from slipping on the operating table
    • Insertion of a transurethral bladder catheter
    • Attachment of a cervical adapter
  2. Anesthesia examination and placement of a cervical adapter

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    Anesthesia examination and placement of a cervical adapter
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    Under anesthesia, the mobility and degree of the prolapse are assessed in detail. This includes:

    • Prolapse of the anterior compartment (cystocele): Assessment of the bladder base.
    • Prolapse of the middle compartment (descent of the cervix)
    • Prolapse of the posterior compartment (rectocele): Condition and descent of the rectum.

    Placement of the Hohl portio adapter:

    A tenaculum is used to securely grasp the portio vaginalis of the cervix. The portio is carefully grasped with the tenaculum. A targeted caudal traction is applied to stretch the uterus and optimize the anatomical conditions. This facilitates the introduction of the further components of the portio adapter. The intracavitary probe is carefully inserted into the cervical canal lumen, taking care not to cause perforation or excessive tension. The threaded piece is securely positioned and fixed into the cervix uteri by rotational movements.

Trocar positioning

Incision infraumbilical. Before introducing the Veress needle, the abdominal wall should be lifted

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