Fig. 1.

Ligaments cutting method in TAH: For the prevention of ureteral injury, the principle of ligament transection is to begin from a safe ligament far from the ureter, and it is important that the ureter is kept away from the cervix at each transection stage. The second important point is to ligate and cut the parametrial ligaments along the roundness of the uterine cervix (A). If you cut along the same cross section as B without following the roundness of the cervix, ureter damage is likely to occur in the location shown by the arrow. (Reproduced with permission from 1. Hiramatsu Y. Basic Procedure 1. In: Hiramatsu Y, Konishi I, Sakuragi N, Takeda S, eds. Mastering the Essential Surgical Procedures OGS Now, No.2 Total Abdominal Hysterectomy (Japanese). Tokyo: Medical View; 2010: 42–55. Copyright © Medical View).