Laparoscopic ligation of hypogastric arteries using the Hulka clip to arrest massive vaginal bleeding due to stage IIb cervical carcinoma

Abstract

A woman experienced severe vaginal bleeding from an exophytic, eroded cervical carcinoma. When vaginal tamponade and blood transfusion were ineffective in stopping the hemorrhage, bilateral laparoscopic ligation of the hypogastric arteries was performed. A Hulka clip was used to collapse the artery walls. Two months post-operatively a second, minor episode of bleeding occurred. This might have been avoided by ligating the ovarian-uterine anastomosis.