3-Day Advanced Surgical Training in Vaginal Hysterectomy
The Non-Descent Vaginal Hysterectomy (NDVH) Training Program is designed for gynecologists seeking focused training in the vaginal approach to hysterectomy for appropriately selected benign gynecological conditions.
The program combines patient selection, pelvic surgical anatomy, operative planning, and stepwise surgical technique with supervised operating-theatre exposure. Particular emphasis is placed on understanding when the vaginal route is appropriate and how to safely manage challenging anatomy.
Surgical Training Framework
Select → Assess → Mobilise → Control → Remove → Secure → Review
Participants are introduced to the complete operative pathway, with faculty guidance throughout the surgical sequence and emphasis on anatomical orientation, haemostasis, and safe tissue handling.
Core Training Areas
Patient Selection & Preoperative Planning
Participants review the factors that influence suitability for NDVH, including:
- Uterine size and mobility
- Vaginal accessibility
- Pelvic anatomy
- Underlying uterine pathology
- Previous pelvic surgery
- Associated adnexal disease
- Suspected adhesions
- Circumstances requiring an alternative surgical route
The program emphasizes route selection and surgical judgement alongside technical skill.
Operative Anatomy
Focused teaching covers the anatomical structures encountered during vaginal hysterectomy:
- Cervix and vaginal fornices
- Anterior and posterior surgical planes
- Uterine vessels and parametrial tissues
- Cardinal and uterosacral ligaments
- Ureteric course
- Pelvic sidewall
- Peritoneal entry points
Understanding these relationships is essential for safe dissection and prevention of urinary or vascular injury.
Stepwise NDVH Technique
The operative sequence is taught through demonstration and supervised clinical exposure:
Exposure → Plane Development → Pedicle Control → Uterine Mobilisation → Detachment → Extraction → Haemostasis → Vault Closure
Training addresses the principles of:
- Vaginal incision and tissue-plane development
- Bladder mobilisation
- Posterior cul-de-sac entry
- Pedicle identification and control
- Uterine vessel management
- Uterine mobilisation and removal
- Haemostasis assessment
- Vaginal vault closure
Managing Difficult Cases
The program also examines modifications that may be considered when vaginal access or uterine extraction is challenging.
Case discussions include:
- Bulky or enlarged uterus
- Leiomyomatous uterus
- Limited uterine descent
- Restricted vaginal access
- Previous pelvic surgery
- Adhesions
- Distorted pelvic anatomy
Techniques such as bisection, coring, and myomectomy for uterine debulking are discussed where clinically appropriate. The limits of the vaginal approach and situations requiring conversion or an alternative route are also addressed.
Operating Theatre Training
Practical learning is centred around real surgical cases where available.
Observe → Assist → Participate Under Supervision Selected Steps → Review
Participants may receive supervised exposure to relevant operative steps according to their experience and the clinical circumstances.
Hands-on participation is subject to patient suitability, case availability, informed consent, institutional protocols, faculty assessment, and individual competence.
Participants may also propose suitable cases from their own practice, subject to prior assessment and institutional approval.
Complication & Safety Management
The program incorporates recognition and prevention of complications encountered during vaginal hysterectomy, including:
- Haemorrhage
- Ureteric or bladder injury
- Bowel injury
- Pelvic or vaginal haematoma
- Difficult dissection
- Inadequate haemostasis
Faculty-led discussions focus on anticipation, early recognition, and appropriate management of operative difficulties.
3-Day Training Curriculum
Day 1 - Selection, Anatomy & Operative Planning
Patient assessment, route selection, pelvic anatomy, surgical planes, instrumentation, and preparation for NDVH.
Day 2 - Operative Technique
Stepwise demonstration of NDVH, pedicle management, uterine mobilisation, extraction, and vault closure, with operating-theatre exposure where available.
Day 3 - Challenging Cases & Surgical Integration
Management of enlarged or difficult uteri, debulking techniques, complication prevention, case discussions, and supervised operative exposure.
Learning Outcomes
By completing the program, participants should be able to:
- Assess suitability for the vaginal route
- Apply relevant pelvic surgical anatomy
- Plan the operative sequence systematically
- Understand safe pedicle and uterine vessel management
- Develop appropriate surgical planes
- Apply techniques for selected difficult uteri
- Recognize situations where NDVH may not be appropriate
- Identify and respond to important operative complications
Who Should Attend?
The program is intended for:
- Gynecologists & Obstetricians
- Residents in Obstetrics & Gynecology
- Fellows in Gynecological Surgery
- Qualified clinicians seeking focused training in vaginal hysterectomy
Program Details
- Duration: 3 Days
- Location: Delhi
- Format: Intensive Clinical & Surgical Training
- Focus: Non-Descent Vaginal Hysterectomy
- Training: Academic Sessions + Operative Demonstration + Supervised Clinical Exposure
- Batch Size: Limited Participants
- Certification: Certificate of Completion
Advance Your Vaginal Surgery Skills
Develop a structured approach to patient selection, pelvic anatomy, and NDVH technique, with focused training in operative planning, challenging cases, and safe surgical practice.
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