▸ Vulsellum forceps. These are useful for grasping myoma. Lahey, Gordon, and Segond forceps are all good options.
▸ Myotomes. Cobb and Langenbeck periosteal elevators that have been modified into both chisel tip and spoon tip myotomes can be helpful for enucleation.
With the proper equipment and surgical skills, vaginal hysterectomy is feasible in most cases, and the reduced morbidity, costs, and hospital length of stay associated with this approach should be enough incentive to encourage gynecologists to increase proficiency in the vaginal approach, Dr. Zimmerman said.
Keep in mind, he added, that in appropriately informed patients who have given consent to surgery, conversion to a more invasive approach is not a complication.
Dr. Zimmerman is a speaker/proctor for Cook Medical, proctor for Boston Scientific Corp. and Covidien, and receives Royalties from Lumitex Inc. and Marina Medical Instruments Inc.