Identification of the ureter and ligating the uterine artery during hysterectomy

With sharp dissection, the ureter is dissected free of its soft tissue attachments from its point of entry into the pelvis to its insertion into the bladder. The uterine artery is then identified, divided at its origin, and reflected medially. Identification of the uterine artery can be facilitated by placing downward tension on the superior vesical artery on the ipsilateral side. This causes all of the branches of the internal iliac artery to be tensed and makes them more readily identified.