Non-Descent Vaginal Hysterectomy Made Easy

by Sudhir R Shah, Beena N Trivedi, Dipal D Solanki

More and more gynecologic surgeons are doing this surgery routinely and the numbers of indications have increased a lot. Previous 2 LSCS—Large fibroids uterus—Removal of ovaries with uterus—has become easy with more experience and understanding of surgical steps. The purpose of bringing out the second edition of this book is to motivate more and more gynecologists to perform vaginal hysterectomy in non-descent uterus in normal way. It is just the outcome of what we read, watch and listen at various conferences and learnt out of our surgical practices. It can just be used as ready reference book. For any author publication of second revised edition of his book is a dream. Today the dream has come true for us. In this revised edition we have reviewed few chapters giving some extra tips. It is a matter of pride for us that our research needle–SRS Needle—is in market now and available easily. Details have been given in Chapter 7. Some new photographs have been included in Chapter 6. They are the snaps of our NDVH cases. Average gynecologist is afraid to perform vaginal hysterec­tomy if there is no uterine descent. This is due to lack of proper training and exposure by the teachers during residency. Now with entry of laparoscope, more attention is paid to removal of the uterus with laparoscopic approach. There is enough data to show that vaginal approach for non-descent uterus has more advantage than abdominal approach. It is pleasing to note that attempts are made to revive vaginal hysterectomy for non-descent uterus. At least 60% hysterectomies are performed for dysfunctional uterine bleeding (DUB) where the uterus is normal or slightly enlarged. The book is very well written giving details about various important steps including patient selection, pre-operative care, surgical technique and finally postoperative follow-up. This inquiring state of mind is responsible for the spirit of dedication and resourcefulness. Modification of the slandard Butterfly needle for use as short straight needle simplifies the surgical technique when working space is minimal. This short book kindles the desire among the gyneco­logists to vaginal approach for hysterectomy even when there is no uterine descent. The need for abdominal hysterectomy should be much less if the technique for vaginal approach is mastered.

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