Three–port robotically assisted laparoscopic hysterectomy (RALH) in case of severe adhesions: A didactic video

Abstract

Post cesarean adhesiolysis during hysterectomy may be sometimes challenging, especially in case of associated adenomyosis or endometriosis. Nowadays, more and more surgeons use robotic assistance to perform laparoscopic hysterectomy. The number and size of trocars may influence postoperative pain. We present in a video a robotically assisted laparoscopic hysterectomy (RALH) using only two instruments and trocars to perform a difficult post cesarean adhesiolysis with removal of associated endometriosis.

Surgical platforms and instruments in robotic hysterectomy using the da Vinci Xi system

“…A previous study reported the safety and feasibility of the three-port robot-assisted hysterectomy technique [18]. This technique consists of three 8-mm trocars: one port on the umbilicus for a 0° or 30° optic and two lateral 8-mm ports for the instruments [18,19]. A 30° optic can be useful in cases that allow access to uterine arteries and vesicovaginal fold or culdotomy in some cases with large uteri.…”