Total laparoscopic hysterectomy (TLH) in patients with previous cesarean section



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This video demonstrate Total laparoscopic hysterectomy (TLH) in patients with previous cesarean section performed by Dr R K Mishra at World Laparoscopy Hospital. Total laparoscopic hysterectomy (TLH) in the presence of patients with previous cesarean section (CS) is becoming increasingly common. When performing TLH in these patients, bladder adhesions to the uterus may make dissection much more difficult with higher complication rates. In patients with previous CS, these risks are much higher and principally related to major blood loss or urologic injuries. Careful bladder dissection is important. This is of outmost importance when mobilizing the bladder off the cervix, a critical step during any hysterectomy. Thus, making the abdominal route a safer alternative for gynecologic surgeons who have been better trained with open surgery.