lap hysterectomy with real case

1. Laparoscopic hysterectomy
Harith Riyadh Abdullah Ghrairi
Akaki tsereretli stat university
Semester XI GROUP C
Supervisor
Dr Mariam kukhalashviliDate: June 2019

2. HYSTERECTOMY
IS THE SURGICAL
REMOVAL OF THE
UTERUS (THE
"WOMB").
There are several types of
hysterectomy, depending on the
precise structures of the pelvis that
are surgically removed. These
include:

3. INDICATION
• Uterine fibroids (this is the most common reason
for hysterectomy)
• Endometriosis
• Pelvic support problems (such as uterine
prolapse)
• Abnormal uterine bleeding
• Chronic pelvic pain
• Gynecologic cancer

4. METHODS OF
HYSTERECTOMY
Laparoscopy
Vaginal
Laparotomy
Robot

5. Comparing methods of hysterectomy (British Journal of Ob-Gynae 2009)
N- 4505 ( during 1990-2006 years)
. By laparoscopy 3190
. By the vaginal route 906
. By laparotomy 409

7. The first laparoscopic hysterectomy (LH) was
performed in January 1988 by Harry Reich in
Pennsylvania

8. Instruments:

9. 10 Steps Toward a Successful TLH
1. Preparation and Positioning

10. 2. Insertion of a Uterine Manipulator
3. Abdominal Entry and Trocar Placement

11. 4. Hug the Ovaries
5. Mobilize the Bladder

12. 6. Secure the Uterine Vessels
7. Separate the Uterus and Cervix From the Vaginal Apex

13. 8. Removal of the Uterus
9. Vaginal Cuff Closure

14. 10. Port Site Closure
Lap. Hysterectomy
post op picture.

15. Case 1
69 years old woman with history of
vaginal bleeding last week .. She
has 3 child and 2 abortions and
appendectomy at 30 years old .. In
US examination find thinking of
endometrium .. And after taking
biopsy find atypical endometrium
non cancer … Dr recommend
endoscopic Total hysterectomy
..which is don by Dr Samlome
chikhladze .. After operation also
find some of polyps

16. Case 2
48 years old fatty woman
with history of of chronic
pelvic pain. She have 2
child with 3 abortion ..
After examinations find out
she have big mass of
lieomyoma . She
recommended for total
hysterectomy

17. thanks for attention
Thanks for
Dr Salome chikhladze Dr Mariam
kukhalashvili

18. . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673000/
https://www.ncbi.nlm.nih.gov/pubmed/7333047?fbcl
id=IwAR14ePHXYXPmRv17YURJSdmS5JRGRzc
ejdMO4QR4sMwwkSxOS5_FMSAcL28
https://www.acog.org/Patients/FAQs/Hysterectomy?IsMo
bileSet=false&fbclid=IwAR01kApNyIqXeFFzlQJVpbm9O
21HjuAXsF_oX36UTRN8Fr1d0ZWUkjeRwxg
https://www.medicinenet.com/hysterectomy/article.htm?f
bclid=IwAR18_AX3BvvcbL0DFBnAylnuOL3E2_ohs5jZVi
ZO0AwjT1BRvvmo4Y1ySbI
https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1471-
0528.2008.01966.x