case_images: PMC10925680_01
case_images: Utero-ovarian transposition. (A) The round ligaments are transected, the anterior leaves of the broad ligaments are dissected caudally, and the vesicouterine space is dissected to mobilize the bladder and expose the anterior vagina. (B) The infundibulopelvic ligaments are dissected and mobilized. (C) Uterine vessels are coagulated and cut at the uterine pedicles. (D) Uterus and adnexa perfusion is assessed using near-infrared fluorescence technology with an intravenous injection of indocyanine green. (E) Cardinal and uterosacral ligaments are sectioned, and a circular colpotomy is performed at the level of the cervicovaginal junction. (F) The uterus and adnexa are transposed to the upper abdomen and fixed to the anterior abdominal wall with transabdominal sutures. RL, round ligament; IL, infundibulopelvic ligament; UA, uterine artery.
case_images: fsurg-11-1336047-g002.jpg
case_images: PMC10925680_01_fsurg-11-1336047-g002.jpg
case_images: F2
case_images: Trendelenburg position. To perform the surgery, we used conventional laparoscopic instruments with monopolar, bipolar, and ultrasonic energies (Figure 2).
case_images: Utero-ovarian reimplantation. (A) The uterus and adnexa are freed from the adhesions, and attachments to the anterior abdominal wall are sectioned. (B) The vaginal vault is re-opened. (C) The uterus and adnexa are repositioned into the pelvis, and the cervix is introduced into the vagina through a Gelpoint vPath (9.5 cm) and sutured to it transvaginally. (D) The round and broad ligaments are sutured to the pelvic sidewall to their natural position.
case_images: fsurg-11-1336047-g003.jpg
case_images: PMC10925680_01_fsurg-11-1336047-g003.jpg
case_images: F3
case_images: Six weeks after the end of radiotherapy, TaTME and uterus repositioning were performed (Figure 3).