How is uterine artery ligation performed?

How is uterine artery ligation performed?

A large atraumatic (round) needle is used with a heavy absorbable suture. Include almost the full thickness of the myometrium to anchor the stitch and to ensure that the uterine artery and veins are completely included. The needle is then passed through an avascular portion of the broad ligament and tied anteriorly.

What is the success rate of uterine artery ligation?

Uterine artery embolization and uterine artery ligation both have reported success rates of greater than 90% with low complication rates. If both techniques are available, embolization is the preferred first choice as it obviates laparotomy, and ligation can be attempted subsequently if embolization is unsuccessful.

Is UAE less successful after uterine artery ligation?

UAE is a less invasive technique that has success rates similar to UAL [1]. The advantage of utilisation of UAE early in the management protocol of severe refractory PPH has been well documented. In case of failure, surgical techniques (arterial ligation/hysterectomy) can be undertaken without any hindrance.

Is retroperitoneal dissection required for uterine artery ligation?

Retroperitoneal dissection to ligate the uterine artery at its vascular origin can circumvent these obstacles, resulting in a safer procedure. However, detailed anatomic knowledge of the course of the uterine artery and understanding of vascular variations are essential for optimal dissection.

What is uterine artery ligation?

Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear.

What is artery ligation?

With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat.

Is uterine artery ligation first line?

When conservative management is feasible, the first line approach should be bilateral distal ligation of the uterine arteries: this simple and low-risk technique is immediately effective in 80% of cases.

Which artery is ligated during hysterectomy?

Uterine artery ligation at the beginning of total laparoscopic hysterectomy reduces total blood loss and operation duration.

What is the difference between UFE and UAE?

UAE applies generically to any procedure where the uterine arteries are embolized, such as for emergency post-partum or post-operative bleeding, or in this case, electively for fibroids. UFE applies specifically to embolizing the uterine arteries for the purpose of treating symptomatic fibroids.

Does embolization hurt?

Most patients experience some side effects after embolization. Pain is the most common and can be controlled by medication given by mouth or through your IV. Women who have embolization of fibroid tumors may have severe pain or cramps shortly after the procedure and for eight to 12 hours afterward.

Does uterine artery ligation cause infertility?

Conclusions: Uterine artery ligation, whether or not associated with utero-ovarian ligament ligation, for PPH does not appear to compromise the patients’ subsequent fertility and obstetrical outcome.

Where do you Ligate uterine arteries?

If the artery has been torn, clamp and tie the bleeding ends. Ligate the utero-ovarian artery just below the point where the ovarian suspensory ligament joins the uterus (Fig P-53). Repeat on the other side.

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