Instructional Video on Performing an Efficient Vaginal Hysterectomy for the Tech Savvy Trainee

Study Objective Historically, surgery was learned in the operating room after first reading step-by-step instructions in a well-respected and well-illustrated text-book. Today, with technology at their fingertips, young surgeons seek and utilize video for learning surgical procedures. Often however, the more important “why” behind many surgical steps is left out. Our objective therefore, was to marry the demonstration of the anatomy with the why in order to provide a more complete experience for the learner. Design N/A Setting Operating room. Patients or Participants Patients undergoing planned hysterectomy for pelvic organ prolapse repairs who provided consent for filming. Interventions We carefully walk through performing the steps of a complete vaginal hysterectomy. We begin with identifying the cervix, and finish demonstrating how to check the pedicles for occult bleeding once the uterus and cervix are removed. We include tips and tricks within the video with specific benefits related to each suggestion, to help provide the "why". We cover many of the most challenging areas for new surgeons in completing a successful vaginal hysterectomy. We cover plane development, efficient tying technique, aids for visualization, introduction of a modified Heaney stitch, which brings each pedicle together, closing the gaps between them and greatly reducing blood loss, and provide and demonstrate other pearls throughout. Measurements and Main Results N/A Conclusion If performed correctly, utilizing the techniques and tips included in this instructional video, the gynecologic trainee will enter the operating room for their first hysterectomy, empowered with knowledge and understanding that typically are learned during their first five to ten cases. Thus, empowering them with a framework for not only success in their first case, but one they can carry with them through their career.