Vaginal Hysterectomy

Many of the physicians and students we encounter in our GO GYNS program have experience performing abdominal hysterectomies, but few have practiced vaginal hysterectomies. Vaginal hysterectomies are associated with better results and fewer complications than laparoscopic and abdominal hysterectomies. Whenever possible, a vaginal hysterectomy is the safest and most economic method to remove the uterus. 

 Dr. Rachel Hartshorn holds a model uterus used for vaginal hysterectomy simulations. 

Dr. Rachel Hartshorn holds a model uterus used for vaginal hysterectomy simulations. 

Materials:

  • 1 pool noodle 2.5” diameter (for uterus and cervix)
  • 8 long balloons (for ligaments and blood vessels)
  • 2 cotton balls and 2 long balloons cut in half (for ovary/utero-ovarian ligament and fallopian tube)
  • 8 x 12” piece of 4 way stretchable fabric (used for swim suits, for vagina/vaginal canal)
  • 2 x 2” piece of cotton cloth (for bladder)
  • Scissors/knife
  • Sewing machine
  • Spray glue
  • Press and Seal wrap
  • Needle and thread or any available suture with needle

Instructions:

 Dr. Teresa Munoz assists with a vaginal hysterectomy simulation in Nicaragua. 

Dr. Teresa Munoz assists with a vaginal hysterectomy simulation in Nicaragua. 

  1. Cut the pool noodle into 6 inch pieces, 1 piece = 1 Uterus/cervix
  2. Use scissors or knife to taper the last 1-2” of each piece
  3. Use sewing machine to sew the 8 x 12” stretchable cloth lengthwise to make a tube approx. 2.5-3” diameter
  4. Turn the tube inside out and place the pool noodle inside with the tapered end about 1” from the end
  5. Fold the fabric back over, spray with glue and fold back
  6. Pull fabric down to expose pool noodle
  7. Using needle with thread or any available suture, attach the full-length long balloons in pairs (4 x 2 = 8) to the pool needle at the correct anatomical position. The balloons represent uterosacral ligaments, uterine arteries, cardinal ligaments, and round ligaments
  8. Cut 1 full-length long balloon in half to make utero-ovarian ligaments
  9. Attach one balloon to each cotton ball ovary, then attach to the pool noodle in the correct anatomical position
  10. Cut 1 full-length long balloon in half to make Fallopian tubes and attach them to the pool noodle in the correct anatomical position
  11. Glue the 2 x 2” piece of cotton cloth to the lower anterior uterus
  12. Cover the entire model with Press and Seal

The model we use in our simulations was developed by a group of physicians from Johns Hopkins University. A video demonstrating how to make and use the model can be found here:

The following manual for making and using the model is shared with permission from ACOG. 

References:

  1. Validation of a low-cost VH simulation model for surgical education, Altman et al, JMIG, 2014, PDF Here
  2. ACOG Simulation working group Took Kit, Vaginal hysterectomy: Flower pot model simulation, VH simulation, Altman et al, PDF Here
  3. Simulation model for vaginal hysterectomy video, Memon et al, Video Here