Section-03 Vaginal Hysterectomy with Adnexal Pathology

BOOK TITLE: Advanced Vaginal Surgery

1. Sheth Shirish S
Publishing Year
Author Affiliations
1. Breach Candy Hospital, Sir Hurkisondas Nurrotamdas Hospital and Sheth Nursing Home, 2/2, Navjivan Society, Lamington Road, Mumbai, India, e-mail:silsal@bom2.vsnl.net.in, Breach Candy Hospital and Sir Hurkisondas Nurrotamdas Hospital, Mumbai, silsal@bom2.vsnl.net.in, Sir Hurkisondas Nurrotamdas and Saifee Hospitals, Mumbai, Maharashtra, India, Breach Candy Hospital and Sir Hurkisondas Nurrotamdas Hospital, Mumbai, Maharashtra, India, Breach Candy Hospital, Sir Hurkisondas Hospital and Saifee Hospital, Mumbai, Maharashtra, India, Mumbai, King Edward Memorial Hospital and Seth GS Medical College, Mumbai, Maharashtra, India (1964–1994); International Federation of Gynecology and Obstetrics (FIGO) from 2000–2003; Breach Candy and Saifee Hospitals, Mumbai, Maharashtra, India
Chapter keywords
Vaginal hysterectomy, VH, infundibulopelvic ligament, IPL, abdominal hysterectomy, AH, salpingo-oophorectomy, ovarian cyst, broad ligament fibroid, BLF


This section focuses on vaginal hysterectomy with adnexal pathology. For salpingo-oophorectomy at vaginal hysterectomy (VH), cutting and ligating round ligament separately and distally is a “MUST” and that alone facilitates and paves the way to clamp infundibulopelvic ligament (IPL). Just as at abdominal hysterectomy (AH), the round ligament is cut separately and as laterally as possible to create a space and apply a clamp to the IPL for salpingo-oophorectomy; the same principle needs to be applied when salpingo-oophorectomy is attempted vaginally. This section comprises of 9 sections that are described as VH with BSO for large bilateral hydrosalpinx, VH with left salpingo-oophorectomy for ovarian endometrial cyst in morbidly obese with past history of two caesarean sections, VH with BSO for left ovarian endometrial cyst and right ovarian teratoma with history of two caesarean sections, VH with BSO for bilateral ovarian endometrial cysts with positive “Dimple Sign”, VH with BSO for a solid ovarian tumor, VH with BSO followed by laparotomy for ovarian cyst (failed “trial vaginal route” because of ovarian “CA”), VH with BSO and right broad ligament myomectomy for right broad ligament fibroid (BLF), and VH with BSO for twisted left ovarian cyst.

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