Poor Visualization Leads to Ureteral Injury during Hysterectomy

A patient arrived at the hospital with pelvic pain. The OB/GYN surgeon performed a laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy. The surgery was intended to be entirely laparoscopic, but the RUMI uterine manipulator would not form a seal of the cervix and kept becoming dislodged. As a result, the physician had to remove the uterus vaginally, a technique they …