Total Laparoscopic Hysterectomy

Making Easy-
The Technique and Tools
:- A 8 -Year Experience

Dr. Mohammad Abdul Quayyum

MBBS, FCPS
Consultant (Gynae)
Gynaecologcal Endoscopic surgeon
Feni Pvt Hospital , Bangladesh

E-mail : quayyum1959@gmail.com 1
 November 7, 2010, Recommendation of the AAGL – Most
Hysterectomies Should be Performed Vaginally or Laparoscopically

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 Introduction
Laparoscopic techniques are being used increasingly
more in gynecologic surgery

In 1989 Harry Rich performed 1st Total Laparoscopic

Hysterectomy (TLH).

Original Operation has not change but techniques and

tools are changed for safe operation.

During operation the main problems are:

Absence of landmarks.

Injury to Ureter, Bladder and Rectum etc.

Maintenance of Pnemo-peritonium.

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HOW TO OVER COME THIS PROBLEMS

The Q-Colpotomizer™ system

(Simplified.TLH.technique)
- A very simple, safe and easily available tools.
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Differents uterine manipulators

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 Q-Colpotomizer™ system
Purandare uterine manipulator
Tintara uterine manipulator
Q- Colpotomizer cup – 3, 3.5 4 cm
Pneumo-occluder- sterile wet sponge- 7.5 x12 cm size

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Video presentation showing techniques and tools of TLH :-
Purandare uterine manipulator.
Q- Colpotomizer- Cup .
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Pneumo-occluder - 3-4 pieces sterile sponge wet
 Laparoscopic View

Anterior Laparoscopic View Posterior Laparoscopic View

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The Inside Story (TLH)

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Intraoperative bladder injury
 Result
January 2008 to December 2015= 1024 TLH

Mean age (range)- 47.3 yrs (26–62 years)

successful TLH - 1018 (99.4.%)
Very minimum gas leakage .
Six (0.6 %)cases were converted to
Laparotomy.
Mean operating time was 62 (24–175)min
Intraoperative bladder injury- 1.
Uretero-vaginal Fistula - 1 .
Mean hospital stay was 2.3 days (1–5).
 Conclusion
At the end we can say

The simplified technique of TLH is simple, safe,

least traumatic & highly illustrative intrafascial
hysterectomy carried out successfully by the
Q-Colpotomizer™ system associated with a
high success rate and very low morbidity.

Thank You E-mail : quayyum1959@gmail.com

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