Total Vaginal Hysterectomy and McCall Culdoplasty

This video displays a unique technique that would provide the surgeon more confidence to perform vaginal hysterectomy, adnexectomy, and vault suspension. The key steps described are: posterior colpotomy, taking full thickness bites of the uterosacral and cardinal ligaments, blunt anterior colpotomy with minimal risk of cystotomy, securing the superior pedicles, and safe adnexectomy. Apical support is achieved by McCall culdoplasty and creating a new vaginal apex. The uterosacral and cardinal ligaments are reapproximated in the midline recreating central support to the vagina and apex. The procedure is concluded with the performance of cystoscopy to assure ureteral patency. Created by Hemikaa Devakumar, MD, Neeraja Chandrasekaran, MD, Alexandriah Alas, MD, Laura Martin, DO, Eric Hurtado, MD, and G. Willy Davila, MD. Used with permission.