Proximal Uterine Artery Ligation: Navigating Anatomical Distortion of Large Fibroids During Hysterectomy

Apr 15, 2019 | 213 Views

Wilson Chan, Chandrew Rajakumar

This video outlines a technique for performing ligation of the proximal uterine arteries. This is a technique that can be used to mitigate blood loss during hysterectomy.

Uterine & Internal Iliac Artery Ligation: Anatomy and Clinical Applications for Benign Gynecology

Apr 15, 2019 | 243 Views

Ally Murji, Mara Sobel, Nicholas Leyland

This video reviews the surgical vascular anatomy and techniques for ligating the uterine arteries at their original, or the anterior division of the internal iliac arteries.

Uterine Artery Occlusion at Myomectomy

Sep 27, 2019 | 330 Views

Andrew Zakhari, Ari Sanders, Ally Murji

In this video, we demonstrate three approaches to uterine artery occlusion at time of laparoscopic myomectomy as a blood-sparing intra-operative technique. A step-wise approach is applied prior to beginning the myomectomy which includes the following: 1) Selecting the appropriate approach to uterine artery occlusion (lateral vs. posterior vs. anterior) based on individual anatomy; 2) identification of relevant anatomy and important landmarks for the procedure 3) isolating the uterine artery and identifying the ureter; 4) occluding the uterine artery. As illustrated in this video, uterine artery occlusion can be performed by three different approaches, depending on both surgeon preference and unique patient anatomy. A systematic review and meta-analysis of the literature supports the efficacy of this procedure in terms of limiting blood loss, blood transfusion, and fibroid recurrence, albeit at slightly longer operative times.