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This video demonstrates Total Laparoscopic Hysterectomy by three 5 mm ports by Dr. R K Mishra at World Laparoscopy Hospital. It is surgery we have also used stryker Ukit for added safety. Total laparoscopic hysterectomy is a safe and effective procedure for women needing a hysterectomy. We enjoy a high operative volume and perform approximately 150 total laparoscopic hysterectomy cases annually with a conversion rate of 1:500. The steps described herein are not meant to be an absolute truth, but rather a true and tested method that has served us well to safely accomplish this procedure.

Total Laparoscopic Hysterectomy (TLH) is an advanced minimally invasive surgical procedure used for the removal of the uterus using laparoscopic instruments. The evolution of port reduction surgery has led to the development of techniques using smaller and fewer ports. One such refined technique is TLH performed using three 5 mm ports, which offers excellent cosmetic outcomes, reduced postoperative pain, and faster patient recovery. This advanced technique is routinely taught and practiced at leading minimal access surgery training centers such as World Laparoscopy Hospital.

Total Laparoscopic Hysterectomy is indicated for various benign and selected malignant gynecological conditions such as fibroids, adenomyosis, abnormal uterine bleeding, and early-stage endometrial cancer. The three-port 5 mm technique represents the next step toward scarless and patient-friendly surgery without compromising safety or surgical precision.

Surgical Technique Overview

In the three 5 mm port TLH technique:

• One 5 mm port is placed at the umbilicus for the laparoscope

• Two additional 5 mm working ports are placed in the lower abdomen

• Advanced energy devices are used for vascular sealing and tissue dissection

• The uterus is detached laparoscopically and removed vaginally or by morcellation if required

The use of smaller ports significantly reduces trauma to the abdominal wall and improves cosmetic results.

Advantages of Three 5 mm Port Technique

1. Minimal Scarring:
Smaller port size leads to almost invisible scars, improving patient satisfaction.

2. Less Postoperative Pain:
Reduced port size means less tissue trauma and decreased need for postoperative analgesics.

3. Faster Recovery:
Patients typically experience early ambulation and shorter hospital stay.

4. Lower Risk of Port Site Hernia:
5 mm ports have minimal risk of hernia compared to larger ports.

5. Better Cosmetic Outcome:
Especially important for young and cosmetically conscious patients.

Training and Expertise

Performing TLH through three 5 mm ports requires advanced laparoscopic skills, precise hand-eye coordination, and deep anatomical knowledge. Surgeons undergo structured training, simulation practice, and hands-on mentorship to master this technique. Under the guidance of experts like Dr R K Mishra, surgeons learn standardized and safe approaches to complex laparoscopic procedures.

Patient Outcomes

Clinical outcomes of this technique show:

• Reduced intraoperative blood loss

• Low complication rates

• Early return to normal activity

• High patient satisfaction scores

Conclusion

Total Laparoscopic Hysterectomy using three 5 mm ports represents the future of minimally invasive gynecologic surgery. It combines surgical safety with superior cosmetic and recovery benefits. With structured training, advanced technology, and expert mentorship, this technique is becoming widely adopted in modern laparoscopic practice, ensuring better outcomes for patients worldwide.

For more information please contact:
World Laparoscopy Hospital
Cyber City, Gurugram, NCR Delhi
INDIA 122002
Phone & WhatsApp: +919811416838, + 91 9999677788