This video demonstrates total laparoscopic hysterectomy (TLH) by Dr. R K Mishra at World Laparoscopy Hospital. Here U kit was used to visualize the ureter. There are several different types of hysterectomy, including: • total hysterectomy, where both the uterus and cervix (neck of the womb) are removed • subtotal hysterectomy, where just the uterus is removed and the cervix is not • hysterectomy with salpingo-oophorectomy (removal of one or both of your ovaries and your fallopian tubes) at the same time. Some laparoscopic hysterectomies are done entirely by keyhole surgery. Others are done partially through your vagina (sometimes called a laparoscopic-assisted vaginal hysterectomy or LAVH). If you are having an LAVH, you might find helpful information in Recovering well: information for you after a vaginal hysterectomy. The type of hysterectomy will depend on your personal circumstances and will be discussed with you by your gynecologist before your operation. You will need an anesthetic for a laparoscopic hysterectomy. This will be a general anesthetic or a regional anesthetic (spinal or epidural).

A Modern, Safe, and Effective Approach to Uterine Removal

Total Laparoscopic Hysterectomy (TLH) is a minimally invasive surgical procedure in which the uterus and cervix are removed entirely using laparoscopic techniques. The use of a U-Kit (Uterine Manipulator Kit) has significantly enhanced the safety, precision, and efficiency of this procedure, making TLH one of the preferred surgical options in modern gynecology.

What Is Total Laparoscopic Hysterectomy?

Total Laparoscopic Hysterectomy involves performing the entire hysterectomy through small abdominal incisions using a laparoscope and specialized instruments. Unlike open surgery, TLH offers excellent visualization of pelvic anatomy with minimal tissue trauma.

This procedure is commonly recommended for conditions such as:

Uterine fibroids

Abnormal uterine bleeding

Adenomyosis

Endometriosis

Chronic pelvic pain

Early-stage gynecologic malignancies (selected cases)

Understanding the U-Kit in TLH

The U-Kit (Uterine Manipulator Kit) is a specialized surgical device inserted vaginally to mobilize and stabilize the uterus during laparoscopic hysterectomy. It allows the surgeon to move the uterus in multiple directions, clearly define surgical planes, and safely delineate the vaginal fornices.

Key Components of the U-Kit include:

Uterine manipulator handle

Cervical cup

Vaginal delineator

Uterine sound and locking mechanism

Advantages of Using U-Kit in TLH

The incorporation of the U-Kit provides several clinical and technical benefits:

Enhanced uterine mobility for better exposure

Clear identification of cervicovaginal margins

Reduced risk of ureteric and bladder injury

Precise colpotomy guidance

Shorter operative time

Improved surgical ergonomics

Step-by-Step Overview of TLH with U-Kit

Patient Positioning & Anesthesia
The patient is placed in the lithotomy position under general anesthesia.

U-Kit Insertion
The U-Kit is inserted vaginally and secured to allow controlled uterine manipulation.

Laparoscopic Port Placement
Small incisions are made for the laparoscope and working instruments.

Devascularization of the Uterus
Uterine vessels and supporting ligaments are coagulated and transected laparoscopically.

Colpotomy Using Cervical Cup Guidance
The U-Kit cervical cup provides a clear landmark for safe circumferential colpotomy.

Removal of the Uterus
The uterus is removed vaginally or morcellated if required.

Vault Closure
The vaginal vault is sutured laparoscopically for optimal healing.

Benefits for Patients

Patients undergoing TLH with U-Kit experience:

Minimal postoperative pain

Reduced blood loss

Faster recovery and shorter hospital stay

Smaller scars and better cosmetic outcome

Early return to daily activities

Postoperative Care and Recovery

Most patients are discharged within 24–48 hours. Light activities can be resumed within a few days, while full recovery typically occurs within 2–3 weeks. Regular follow-up ensures proper healing and early detection of any complications.

Conclusion

Total Laparoscopic Hysterectomy with U-Kit represents a significant advancement in minimally invasive gynecologic surgery. By improving visualization, precision, and safety, the U-Kit empowers surgeons to perform TLH more efficiently while offering patients superior outcomes and quicker recovery. As laparoscopic expertise continues to grow, TLH with U-Kit stands as a gold standard for hysterectomy procedures.