A laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. A small incision is made in the belly button and a tiny camera is inserted. The surgeon watches the image from this camera on a TV screen and performs the operative procedure.

Laparoscopic hysterectomy is a modern minimally invasive surgical technique used for the removal of the uterus through small abdominal incisions using a camera and specialized instruments. Over the years, technological advancements have introduced new methods to improve surgical precision and patient safety. One such advancement is the use of a myoma screw during laparoscopic hysterectomy, especially in cases where uterine manipulation is required or when a uterine manipulator is not used.

A myoma screw is a specialized laparoscopic instrument designed to provide strong traction and secure fixation of uterine tissue or fibroids. Traditionally, it has been widely used in laparoscopic myomectomy for holding and manipulating fibroids during excision. The screw tip is inserted into the tissue, allowing the surgeon to control movement and apply traction safely, improving surgical precision and reducing operative time.
In hysterectomy, this instrument can also be used for uterine manipulation, stabilization, and extraction of tissue, which enhances visualization and control during surgery.

In total laparoscopic hysterectomy (TLH) using a myoma screw, the screw is introduced laparoscopically and inserted into the uterine body to provide traction. This technique can serve as an alternative to the traditional uterine manipulator. The myoma screw allows controlled movement of the uterus without exerting excessive force on the cervix. Studies and surgical reports have shown that using a myoma screw may reduce the risk of cervical trauma and uterine injury while providing a stable operative field.

Another major advantage of using the myoma screw is improved visualization of surrounding structures such as ureters, bladder, and blood vessels. Because the uterus can be manipulated externally through laparoscopic ports, surgeons can perform dissection more precisely and safely. Additionally, eliminating the uterine manipulator may improve postoperative comfort and reduce complications related to internal manipulation.

However, like all surgical instruments, the myoma screw must be handled carefully. Rare complications such as instrument breakage or malfunction can occur and may increase operative time or require conversion to open surgery if not managed promptly. Proper inspection and maintenance of laparoscopic instruments are essential for patient safety.

In conclusion, laparoscopic hysterectomy using a myoma screw is an advanced and innovative surgical approach that offers excellent uterine control, better visualization, and potentially reduced complication rates. With increasing experience and skill among laparoscopic surgeons, this technique is becoming an important alternative to conventional uterine manipulators. It represents a step forward in minimally invasive gynecologic surgery, aiming to improve surgical outcomes and patient recovery.