Colpotomy in total laparoscopic hysterectomy without using an energy source: a new approach

Pandurang Ramchandra Rotithor, IMAX Multispeciality Hospital, Wagholi, Pune, Maharashtra, India


Currently, energy sources are used in the form of either monopolar current or harmonic scalpel for colpotomy in total laparoscopic hysterectomy. This is associated with lateral thermal damage to adjacent organs such as the urinary bladder or lower ureter. The risk of scar dehiscence with this method is higher than that for abdominal hysterectomy. The objective of this new technique is to reduce these complications. The colpotomy is done using a blade and scissors through the vaginal tube without using any energy source. The resulting edge of the cut is sharper than that done by cautery, making it easy to pick full thickness of vagina. Colpotomy with this method is quicker than when using an energy source. There are also no toxic fumes thus visibility is not affected.