This video shows the technical instructions of how to perform a safe hysterectomy in patients with prior surgery, previous infections or deep infiltrating endometriosis. It is explained how to restore the anatomy of the pouch of Douglas and how to dissect the ureter in case of adesions for endometriosis, and how to prepare the bladder flap in patients with previous C-sections.

The video shows how to perform a proctoscopy to check the integrity of sigmoid and rectum after extensive dissection of endometriosis.
The technique and the indications for ureteral stenting are underlined.