This video demonstrates Total Laparoscopic Hysterectomy by Ligasure performed by Dr. R K Mishra at World Laparoscopy Hospital. LigaSure technology has set the industry standard for vessel sealing. The technology has been used in more than 10 million procedures worldwide, and is supported by an ever-growing body of evidence-based research.
 

Total Laparoscopic Hysterectomy (TLH) by Ligasure at World Laparoscopy Hospital

Total Laparoscopic Hysterectomy (TLH) represents a significant milestone in the evolution of minimally invasive gynecologic surgery. At World Laparoscopy Hospital (WLH), TLH performed using the advanced LigaSure vessel sealing system has become a benchmark procedure, combining surgical precision, safety, and faster patient recovery. Under the guidance of experienced laparoscopic surgeons, the procedure reflects the hospital’s commitment to excellence in minimal access surgery training and patient care.

Understanding TLH and the Role of LigaSure

Total Laparoscopic Hysterectomy involves the complete removal of the uterus, including the cervix, through laparoscopic access without the need for a large abdominal incision. Indications commonly include symptomatic fibroids, adenomyosis, dysfunctional uterine bleeding, endometriosis, and early-stage malignancies.

The LigaSure device is an advanced bipolar energy platform designed to seal blood vessels permanently up to 7 mm in diameter. It works by applying a precise combination of pressure and energy to denature collagen and elastin within the vessel walls, creating a secure seal. This technology minimizes thermal spread, reduces intraoperative blood loss, and enhances operative efficiency—making it particularly valuable in TLH procedures.

Surgical Technique at WLH

At World Laparoscopy Hospital, TLH by LigaSure is performed following standardized, evidence-based protocols:

1. Patient Positioning and Port Placement:
   The patient is placed in the lithotomy position with a Trendelenburg tilt. Typically, a 10 mm umbilical port for the telescope and two or three 5 mm ancillary ports are inserted under vision.

2. Uterine Manipulation:
   A uterine manipulator is introduced to facilitate optimal exposure and delineation of anatomical landmarks.

3. Sealing of Ligaments and Vessels:
   Using LigaSure, the round ligaments, ovarian ligaments (or infundibulopelvic ligaments when adnexectomy is indicated), and uterine vessels are carefully sealed and divided. The precision of LigaSure ensures effective hemostasis with minimal smoke and tissue charring.

4. Bladder Dissection and Colpotomy:
   The bladder is dissected downward to prevent injury. Circumferential colpotomy is performed laparoscopically using energy devices.

5. Specimen Removal and Vault Closure:
   The uterus is removed vaginally or by morcellation when appropriate. The vaginal cuff is then sutured laparoscopically, ensuring secure closure and reducing the risk of vault prolapse.

Advantages of TLH by LigaSure

The integration of LigaSure into TLH offers several clinical advantages:

• Reduced Blood Loss: Reliable vessel sealing minimizes intraoperative hemorrhage.

• Shorter Operative Time: Efficient sealing and cutting streamline the procedure.

• Minimal Thermal Spread: Protects surrounding structures such as ureters and bladder.

• Faster Recovery: Smaller incisions lead to less postoperative pain and earlier mobilization.

• Short Hospital Stay: Most patients are discharged within 24–48 hours.

At WLH, these benefits are consistently observed due to meticulous surgical technique and adherence to international safety standards.

Training and Academic Excellence

World Laparoscopy Hospital is globally recognized for its structured laparoscopic and robotic surgery training programs. Surgeons and gynecologists from across the world attend hands-on courses where TLH by LigaSure is demonstrated in live operative sessions. Participants gain in-depth understanding of pelvic anatomy, energy sources, complication management, and ergonomic principles.

The emphasis on simulation-based practice, dry lab training, and supervised live surgery ensures that trainees develop both confidence and competence. This educational approach enhances patient safety and promotes uniformity in surgical standards worldwide.

Conclusion

Total Laparoscopic Hysterectomy by LigaSure at World Laparoscopy Hospital exemplifies the fusion of advanced technology and refined surgical expertise. By leveraging modern vessel sealing systems and standardized laparoscopic techniques, WLH continues to set high benchmarks in gynecologic surgery. The procedure not only improves clinical outcomes for patients but also serves as a model for training the next generation of minimally invasive surgeons.