In this video, we will disscuss that In this video, we present a detailed demonstration of a Total Laparoscopic Hysterectomy (TLH) combined with vault suspension using the round ligament, along with a retrocecal appendectomy. This comprehensive surgical approach addresses both gynecological and gastrointestinal concerns within a single minimally invasive session, showcasing the efficiency and safety of advanced laparoscopic techniques.
 
Procedure Overview:
 
1. Total Laparoscopic Hysterectomy (TLH):
The procedure begins with the complete laparoscopic removal of the uterus. This method minimizes patient morbidity, offers quicker recovery, and reduces hospital stay compared to traditional open surgery. Meticulous dissection and energy sealing devices are used to ligate the uterine vessels and detach the uterus from its supporting structures.
 
2. Vault Suspension Using the Round Ligament:
A unique highlight of this case is the method of vault suspension post-hysterectomy using the round ligament. This technique supports the vaginal apex and helps prevent future vaginal vault prolapse—a common concern after hysterectomy. By repurposing the patient’s own round ligament, we maintain pelvic support without synthetic mesh, enhancing biocompatibility and reducing the risk of complications.
 
3. Retrocecal Appendectomy:
Intraoperatively, a retrocecal appendix was noted. Given the patient’s clinical history and anatomical presentation, a laparoscopic appendectomy was performed. The retrocecal position of the appendix can often complicate removal, but with careful dissection and visualization, the procedure was completed safely and effectively.
 
Key Benefits of This Combined Approach:
- Single-session resolution of multiple surgical issues.
- Minimally invasive access reduces postoperative pain and speeds up recovery.
- Use of autologous tissue for vault suspension eliminates mesh-related risks.
- Clear, high-definition laparoscopic visuals provide educational value for both practicing surgeons and trainees.
 
Conclusion:
This video serves as an educational tool, highlighting the feasibility and benefits of combining TLH with vault suspension using the round ligament, along with a laparoscopic appendectomy in the presence of a retrocecal appendix. Through precise surgical planning and technique, patient outcomes can be significantly optimized.

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