Vaginal Hysterectomy, Uterosacral Ligament Suspension, and Excision of Redundant Vaginal Tissue

1. Inject Local Anesthetic

2. Gain Peritoneal Access Posteriorly

1. Incision
2. Dissection and Identification of Uterosacral Ligaments

3. Tag Uterosacral Ligaments

4. Gain Peritoneal Access Anteriorly

1. Incision
2. Dissection

5. Finish Hysterectomy

6. Tag Uterosacral Ligaments

7. Posterior Wall Repair

1. Excise Redundant Tissue
2. Suture

8. Anterior Wall Repair

1. Excise Redundant Tissue
2. Suture

9. Suspension Sutures

10. Vaginal Cuff Closure

11. Post-op Remarks