Robot Assisted Radical Hysterectomy Unedited Version

Once five ports have been placed in the patient’s abdomen using quarter-inch incisions, the surgeon begins by dissecting the spaces inside the pelvis to define the operating field. Next, the bladder is moved away from the uterus, cervix and upper vagina, and the uterine artery is tied off and cut at its origin from the internal iliac (or hypogastric) artery. The ureter is then completely dissected away from its surrounding tissue, allowing for a resection of the entire parametrial tissue, after which the rectovaginal space is opened by incising the peritoneum and the uterosacral ligaments are resected. Finally the upper vagina is excised and the uterus, cervix, both parametria, the uretral sacral ligaments and upper vagina are all removed en bloc (together) through the vagina, after which the remaining vagina is sutured shut.