Abstract
Methods for overcoming the obstacle of uterine enlargement when performing a vaginal hysterectomy were discussed in Chapter 5. Another significant obstacle to the vaginal approach is a significant lack of uterine descensus. Many other anatomic factors play an important role in the feasibility of vaginal hysterectomy. With experience and good judgment, the surgeon is usually able to select patients for vaginal hysterectomy in whom a relative lack of descensus can be readily overcome. Some operative techniques are described that help the surgeon obtain access to the more superiorly placed pedicles encountered with these uteri. Access to the ovarian pedicles is not necessarily as difficulty and they should be approached on an individual basis as is discussed.
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Hoffman, M.S., Spellacy, W.N. (1995). Lack of Descensus. In: The Difficult Vaginal Hysterectomy. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4323-4_6
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DOI: https://doi.org/10.1007/978-1-4757-4323-4_6
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