What are the first ligaments separated from the uterus during a hysterectomy?

The round ligament is the first ligament that is typically separated from the uterus during a hysterectomy. This structure extends from the uterine fundus and travels through the inguinal canal to the labia majora, acting to anchor the uterus in place and maintain its position in the pelvis.

During the procedure, the round ligaments are often cut early on because they are anterior and lateral to the uterus, making them accessible for separation without requiring extensive dissection. This allows for better visualization and access to the uterus and surrounding structures. By handling the round ligaments first, the surgeon can also minimize tension on the uterus, facilitating easier removal.

In contrast to the round ligaments, the cardinal ligaments, broad ligaments, and uterosacral ligaments are addressed at different stages of a hysterectomy. The cardinal ligaments provide support and vascular supply to the uterus and are generally separated after the round ligaments, while the broad ligaments encompass the uterus and contain various structures. Uterosacral ligaments help support the uterus posteriorly and are generally addressed towards the end of the procedure during the removal of the uterus.