Endometriosis & Fibroids - Total Laparoscopic Hysterectomy


A 46 year old woman presented with very heavy menstrual bleeding and significant associated pain.


Grade IV endometriosis was noted. There was a large uterus - fibroids and adenomyosis (inflamed uterus).


She subsequently underwent a Total Laparoscopic Hysterectomy.

A large uterus - fibroids and adenomyosis.

The bowel is adherent to the left ovary and tube at the pelvic brim.


Bowel is adherent to the posterior cervix and uterus. This is Stage IV endometriosis.


Careful dissection of the right ureter.


The bowel has been mobilised from the posterior cervix and uterus. The left ovary and tube were removed after identification of left ureter. The uterus has been removed and the vaginal vault has been closed with interrupted sutures. The normal and mobile right ovary is seen on the right of the field.