This is a teaching video for rural surgeons to help them learn how to do Hysterectomies under spinal anesthesia in rural areas.

Hysterectomies are one of the most common surgeries all over the world and the life time risk varies from country to country and rages from 20 to 40% [1]. Even in rural areas about 3 to 5 out 1,000 women above 15 years of age had hysterectomies [2].

Hysterectomies are one of the most common surgeries performed in rural areas. Over the years the rural surgeons have developed many minimally invasive methods of performing hysterectomies. Very talented surgeons can comfortably perform vaginal hysterectomies for non–descent uterus. With further experience they have done these even for larger Uterus.

The Gas Less Laparoscopic surgeries offers the best method of removing the uterus in rural areas as it combines the advantages of open and laparoscopic surgeries and are possible under the easily available spinal anesthesia.

What we do is a Gas Less LAVH which could be described as a safe and glorified vaginal hysterectomy for non–descent Uterus. The vaginal dissection is made easy by detaching the attachments to the uterus right up to the cardinal or Mackenrodt's ligament.

The planes between the bladder and the uterus is also opened and dissected from above and also opening is made from the vagina to the pouch of Douglas. The rest of the dissection is similar to vaginal Hysterectomy.

gnanaraj Dr. J. Gnanaraj MS, MCh [Urology], FICS, FARSI, FIAGES is a urologist and laparoscopic surgeon trained at CMC Vellore. He has been appointed as a Professor in the Electronics and Instrumentation Engineering Department of Karunya University and is the Director of Medical Services of the charitable organization SEESHA. He has a special interest in rural surgery and has trained many surgeons in remote rural areas while working in the mission hospitals in rural India. He has helped 21 rural hospitals start minimally invasive surgeries. He has more than 150 publications in national and international journals, most of which are related to modifications necessary for rural surgical practice. He received the Barker Memorial award from the Tropical Doctor for the work regarding surgical camps in rural areas. He is also the recipient of the Innovations award of Emmanuel Hospital Association for health insurance programs in remote areas and the Antia Finseth innovation award for Single incision Gas less laparoscopic surgeries. During the past year, he has been training surgeons in innovative gas less single incision laparoscopic surgeries.

References (click to show/hide)


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