The total laparoscopic hysterectomy involves only small "keyhole" incisions, often made in the navel or abdomen. A total hysterectomy with bilateral salpingo-oophorectomy is a hysterectomy that also involves removing:

1. The fallopian tubes (salpingectomy)
2. The ovaries (oophorectomy)

This video demonstrates Laparoscopic Myomectomy for Large Fibroid Uterus and Cholecystectomy in the same patient by Three Port. With advancements in minimal access surgery, combined laparoscopic procedures are now being performed for treating coexisting abdominal pathologies at the same surgery.

Hysterectomy remains the most common major gynecological operation worldwide. It may be carried out by three different routes and its variations: vaginal, abdominal, and laparoscopic.

At World Laparoscopy Hospital, we performed 245 combined surgical procedures from January 2001to December 2020. The combination included laparoscopic cholecystectomy, various hernia repairs, and gynecological procedures like hysterectomy, salpingectomy, ovarian cystectomy, tubal ligation, urological procedures, fundoplication, splenectomy.

The most common procedure was laparoscopic cholecystectomy with another endoscopic procedure. As long as the basic surgical principles and indications for combined procedures are adhered to, more patients with concomitant pathologies can enjoy the benefit of minimal access surgery.

Minimal access surgery is feasible and appears to have several advantages in the simultaneous management of two different coexisting pathologies without significant addition in postoperative morbidity and hospital stay.

Laparoscopic Cholecystectomy and total laparoscopic hysterectomy through uterine morcellation can reduce the operation time, uterus removal time, and the intraoperative complications and provide comparable postoperative outcomes compared to that through the transvaginal approaches.