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Finally, the arteries and veins connected to the uterus are tied off and severed at the base of the broad ligament.
Using the uterine elevator to retroflex the uterus and then expose the anterior lower uterine segment, I drive each needle medial to the uterine vessels perpendicularly to exit posteriorly as the uterus is simultaneously anteflexed to expose the broad ligament windows (Figures 3 and 4).
In other words, start with a symptomatic 4- to 5-cm fundal subserosal fibroid before approaching the 10-cm broad ligament fibroid.
One with severe hemorrhage underwent laparoscopic hysterectomy, and the other had a hematoma in the broad ligament drained.
SAN DIEGO -- Laparoscopic ligation of broad ligament varicosities in the management of chronic gynecologic pelvic pain is a "safe and relatively simple" procedure, Mark Erian, M.
Using a right-angle dissector placed through the supra-pubic port, a Mersilene stitch is pulled from back to front through windows created in the broad ligament and tied snugly around the isthmus of the uterus, insuring the suture remains flat against the posterior lower segment.
Entering retroperitoneum lateral to the posterior broad ligament avoids uterine expansion.