Mini-laparoscopic hysterectomy

In this video, we show the indications, technique and contraindications of direct port entry in laparoscopic surgery. Although this way of entry is not popular, recent data show that there are no differences in terms of safety for a way of entry (i.e., Veress needle, open laparoscopy, Hasson's technique, direct entry, etc.) when compared to another. We also discuss some hints and tips and tricks to use when performing this entry technique.

Description of the laparoscopic promontofixation using a mesh with intact uterus. The anatomy of the rectovaginal space, lateral pelvic wall, promontorium as well as steps for rectovaginal dissection are described; the principles of using mesh for posterior defect are shown.

This video demonstrates the usefulness of infrared ureteric stents during rectal or colonic resection when there is unusual dense adhesions or mass involving the lateral pelvic wall. In this case, the patient is having a rectal resection due to severe endometriosis and there were dense adhesions between the rectum, uterus and the pelvic wall. The presence of the infrared stents visible by the 3-chip camera allowed the surgeon to mobilize the rectum off the pelvic wall and the uterus without fear of damage to the ureter, which was close by but well outlined.