About Video

In this video case of 42-years-old female patient, present complaints menorrhagia and pelvic pain since one year. Sonography: enlarged globular uterus, Swiss cheese pattern suggestive of adenomyosis. Presumptive diagnosis: adenomyosis. Surgical procedure: To show the technique of TLH with Enseal PTC especially tackling of the uterine pedicle. Left ovarian ligament then fallopian tubes and then round ligament tackled with Enseal PTC and harmonic ACE. Anterior and posterior leaves of broad ligament opened up. Dissection continued parallel to uterine arteries. Uterovesical fold opened up from one round ligament to other and bladder pushed downwards. Left uterine artery and vein skeletonized properly. This vascular pedicle is coagulated at three points superficially. Finally at midpoint of this coagulated part, the pedicle is grasped in full thickness and coagulated. This pedicle is shaved off from the proposed colpotomy site. Same procedure was done on right side. Colpotomy is done using monopolar hook in circumferential manner, specimen removed from vaginal end and sent for HPE. Caena gloves kept in vagina and vault closure with uterosacral suspension done over it, in continuous double layer with vicryl 1-0.