Tips for Performing a Laparoscopic Hysterectomy

Jon Einarsson, MD, PHD, MPH, is a Professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School. Involved in the development of a novel laparoscopic manipulator, Dr. Jon Ivar Einarsson has delivered lectures and published articles on his subspecialty, laparoscopic hysterectomy. 

One lecture, called “Laparoscopic Surgery: Tips and Tricks,” offers advice on completing this type of surgery with as little risk and trauma possible. For example, Dr. Einarsson notes that it is easier to hold and bring the cervix closer with a Sims’ tenaculum rather than a speculum. This grants the surgeon easier access to the cervix so she or he may work with ease.

To perform a Veres entry, surgeons should first go to the deepest part of the umbilicus where the abdominal wall is thinnest. Next, they should make an incision using a hemostat and 15 blade, taking care to go through the skin and dermis only. Using a Kocher clamp, they should attach tubing prior to entry, then go straight in with the Veres needle and listen for a “chirp.” 

The tips Dr. Einarsson offers surgeons will help patients to heal more quickly and with less scarring.

For a Successful Laparoscopic Hysterectomy, Careful Preparation is Key

Trained in his native Iceland and at the Baylor College of Medicine, Dr. Jon Ivar Einarsson is the director of the Division of Minimally Invasive Gynecologic Surgery (MIGS) at Brigham and Women’s Hospital (BWH). Dr. Jon Einarsson also holds a professorship at Harvard Medical School, where he teaches advanced laparoscopic techniques.

In a recent presentation on successful laparoscopic hysterectomy, Dr. Einarsson emphasized the importance of careful preparation and proper positioning. While many preparatory steps seem basic, they nevertheless are essential to the procedure’s success and should never be overlooked. 

For example, the table should be positioned all the way down, and the patient’s arms should always be tucked in the arm holders with padding. In addition, the surgeon should always check all equipment prior to surgery. To make this task easier, doctors should simplify the equipment list as much as possible.