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November 2010 · Vol. 22, No. 11

SURGICAL TECHNIQUES

The difficult vaginal hysterectomy:
5 keys to success

Challenges can be overcome by ensuring overall surgical expertise, adequate exposure, proper entry into the anterior cul-de-sac, good mobility, and competent morcellation


Dr. Gebhart describes the surgical skills necessary to perform vaginal hysterectomy—and how to develop them

Fast Track

To help avert bladder injury during entry into the anterior culde-sac in a patient who has a history of cesarean delivery, stay on the uterus during dissection into the vesicovaginal space

IN THIS ARTICLE

John  A.  Occhino,  MD

Dr. Occhino is Assistant Professor in the Department of Obstetrics and Gynecology at the University of Missouri in Columbia, Mo.

John  B.  Gebhart,  MD, MS

Dr. Gebhart is Associate Professor in the Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, and Fellowship Program Director at the Mayo Clinic in Rochester, Minn.

Drs. Occhino and Gebhart report no financial relationships relevant to this article.

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