Hysterectomy, the surgical removal of the uterus, is one of the most common gynecologic procedures worldwide. It is performed for benign conditions such as fibroids, adenomyosis, abnormal uterine bleeding, endometriosis, and pelvic organ prolapse, as well as for malignant conditions like uterine, cervical, or ovarian cancers.

With advances in minimal access surgery, hysterectomy can now be performed laparoscopically, vaginally, or robotically, reducing postoperative pain, hospital stay, and recovery time. Full video demonstrations of hysterectomy procedures provide surgeons, trainees, and medical professionals with valuable insight into surgical anatomy, technique, and safety principles.

Indications for Hysterectomy

Hysterectomy is indicated in women with:

Benign uterine disorders:

Symptomatic fibroids causing heavy bleeding or pain

Adenomyosis resistant to medical therapy

Chronic pelvic pain due to endometriosis

Recurrent abnormal uterine bleeding

Gynecologic malignancies:

Early-stage endometrial, cervical, or ovarian cancer

Pelvic organ prolapse or uterine infections unresponsive to medical management

Rarely, trauma or obstetric complications

Contraindications include poor general condition, untreated infections, or uncorrected coagulopathies unless urgent surgery is necessary.

Types of Hysterectomy

Abdominal Hysterectomy (AH):

Traditional approach through a lower abdominal incision

Preferred for large uteri, malignancies, or extensive adhesions

Vaginal Hysterectomy (VH):

Removal of the uterus through the vaginal canal

Advantages: minimal external scarring, shorter recovery

Laparoscopic Hysterectomy (LH):

Uses small abdominal incisions, laparoscopic instruments, and a camera

Includes total laparoscopic hysterectomy (TLH) and laparoscopically assisted vaginal hysterectomy (LAVH)

Offers faster recovery, less pain, and better cosmetic results

Robotic-Assisted Hysterectomy:

Provides enhanced precision and 3D visualization

Useful in complex cases or obesity

Surgical Technique (Laparoscopic Hysterectomy)

A full video demonstration of laparoscopic hysterectomy highlights the following steps:

Patient Positioning and Preparation

Patient is placed in dorsal lithotomy position with slight Trendelenburg tilt

General anesthesia is administered

Bladder and bowel are emptied, and prophylactic antibiotics may be given

Port Placement

Umbilical port (10–12 mm) for the camera

Two or three accessory ports (5 mm) for instruments

Ports are placed to allow optimal triangulation and ergonomics

Uterine Mobilization

Round ligaments, ovarian ligaments, and uterine arteries are identified

Careful dissection preserves adjacent structures such as ureters and bladder

Bipolar or harmonic energy devices are used for coagulation and cutting

Detachment of the Uterus

Uterine vessels are sealed and divided

Broad ligaments and supporting tissues are carefully dissected

The uterus is detached from the cervix or vaginal vault, depending on the procedure

Specimen Removal

The uterus is removed through the vagina (in LAVH or VH) or morcellated for laparoscopic extraction

Care is taken to avoid spillage and maintain sterility

Closure

Vaginal cuff or abdominal closure is performed with absorbable sutures

Hemostasis is confirmed and laparoscopic ports are closed

Advantages of Minimally Invasive Hysterectomy

Reduced postoperative pain due to smaller incisions

Shorter hospital stay and faster return to daily activities

Lower infection risk compared to open procedures

Better cosmetic outcomes with minimal scarring

Enhanced visualization of pelvic anatomy for safer dissection

Postoperative Care

Early ambulation to reduce thromboembolic risk

Pain management with oral analgesics

Monitoring for bleeding, infection, or urinary complications

Follow-up to ensure proper healing of the vaginal cuff or abdominal incision

Patients are advised on activity restrictions, including lifting limitations for 4–6 weeks

Educational Value of Full Video Demonstrations

Full video demonstrations of hysterectomy are invaluable educational tools:

Help trainees understand pelvic anatomy and spatial orientation

Illustrate advanced techniques, instrument handling, and energy device use

Highlight potential complications and their management

Improve confidence and technical skills in minimally invasive surgery

Dr. R. K. Mishra’s lectures and videos often provide step-by-step guidance, combining theoretical knowledge with practical demonstration, which is crucial for training surgeons in safe and effective hysterectomy techniques.

Conclusion

Hysterectomy remains a cornerstone procedure in gynecology, with minimally invasive approaches improving patient outcomes and reducing recovery time. Full video demonstrations of hysterectomy, especially by experienced surgeons like Dr. R. K. Mishra, provide critical learning opportunities for gynecologic trainees and practicing surgeons.

By mastering the principles, techniques, and safety measures demonstrated in these videos, surgeons can perform hysterectomy with precision, efficiency, and minimal complications, ultimately benefiting patients with safer, faster, and more effective surgical care.