Which structure is crucial to avoid during total abdominal hysterectomy (TAH)?

The ureters are crucial to avoid during a total abdominal hysterectomy (TAH) because they are responsible for transporting urine from the kidneys to the bladder. During the procedure, there is a risk of injury to the ureters due to their close proximity to the uterus and other surrounding structures.

Damage to the ureters can lead to significant complications, including urinary leakage or obstruction, which may require further surgical intervention and prolonged recovery. Surgeons take meticulous care in identifying and preserving the ureters during dissection, often using various techniques and tools to ensure they remain intact throughout the procedure.

Other structures such as the ovaries, broad ligament, and vagina are typically addressed directly during a TAH, either through removal or manipulation, depending on the specific surgical goals and the patient's condition. However, maintaining the integrity of the ureters is a priority to prevent postoperative complications.