TLH BS与解剖子宫动脉结扎

This is a case of TLH BS with dissection and ligation of uterine arteries for 18-20 weeks myomatous uterus with admission HB=8.5, amount of blood loss was negligible and there was very minimal change in Hb post op
conclusion can be drawn: 1. size of uterus is a relative issue dependent upon surgeo's experience
2. UAL is possible even in a large uterus and it helps a great deal to reduce blood loss
3. Intergrity of pericervical ring which is the sole supporter of vaginal vault could be saved by use of cup manipulators to prevent post hysterectomy vault prolapse

                               
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thanks