Total Laparoscopic Hysterectomy - Adenomyosis

Symptoms

A 46 year old woman presented with heavy menstrual bleeding and painful periods.

Diagnosis

Pelvic Ultrasound was suggestive of adenomyosis. Conservative management including Mirena IUCD was discussed. She requested surgical intervention and thus underwent Total Laparoscopic Hysterectomy with conservation of both ovaries.

The uterus is enlarged - suggestive of adenomyosis.

 
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The bladder is reflected clear of the surgical field.

The left ovary is conserved.

 
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The vault is sutured laparoscopically.

The right ovary is conserved.

 
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The pelvis at the end of the procedure - showing vaginal vault sutures.