PMC5536215_01
Position of trocars.
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With the patient in gynecological position, after the pneumoperitoneum was insufflated to a pressure of 12 to 14 mmHg, we inserted 5 trocars: 11 mm optical umbilical trocar, 11 mm suprapubic trocar, 5.5 mm in lateral border of the right rectus abdominis, 11 mm in the same position on the left side for the Ligasure forceps and 5.5 mm under the right costal margin on the medioclavicular line (Figure 1).
Sectioning left round ligament with Ligasure forceps and the visualization of a blue-gray color in the peritoneal peritoneum.
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The ureters were visualized transperitoneally (Figure 2).
Dissection and opening of the broad left ligament and dissection of the vesico-vaginal plane.
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With an atraumatic 5.5 mm forceps the assistant gently elevates the peritoneum with the bladder, in order to avoid lesions while dissecting the vesical-uterine space, allowing to open the vesical-vaginal plane and sectioning of the vesical-uterine ligaments (Figure 3).