May 30, 2012
42 year old symptomatic lady with previous 2 LSCS with fibroid uterus with endometriosis. Total laparoscopic hysterectomy with bilateral salpingoophorectomy was done on 30/5/2012. Bladder was badly stuck to anterior LUS and cervix . Check cystoscopy was done post procedure.
A combination of sharp and blunt dissection was used to dissect off the bladder.
It is not always that one gets a plane in the midline so one needs to find the right plane even laterally if possible and one even a window of the right plane is found, one uses that window to slowly and steadily get the whole bladder off the cervix. Patience as they say is a great virtue in these surgeries.