Total Laparoscopic Hysterectomy (TLH) in Ventrifixed Uterus by the Comprehensive Canopy Technique, ‘3 Step Technique’

Total Laparoscopic Hysterectomy (TLH) in ventrifixed uterus, is a surgery fraught with challenges stemming from the escalating rates of Cesarean sections (CS) worldwide. The increasing prevalence of ventrifixed uterus, a consequence of deviations from traditional CS techniques, poses challenges during TLH. Key factors for ventrifixed uterus include insufficient hemostasis during CS, leading to severe adhesions, and the adoption of single layer closure and avoiding visceral and parietal peritoneum closure. The chapter delves into crucial aspects such as closure techniques impacting residual myometrium thickness and niche development. TLH in ventrifixed uterus demands meticulous preoperative diagnosis through clinical examination and ultrasound, emphasizing the importance of skilled sonographers. The surgical approach involves strategic laparoscopic port placements, with innovative methods like the Comprehensive Canopy Concept, ‘The 3 Step Technique’ of bladder dissection. Overall, TLH in ventrifixed uterus requires a clear understanding of scar-related complications, requiring tailored surgical techniques to enhance patient safety.