ObjectiveAnalysis of the techniques used for vaginal removal of the adnexa after vaginal hysterectomy.MethodsA prospective evaluation of 100 patients who had undergone vaginal salpingo-oophorectomy after vaginal hysterectomy was performed. The adnexal anatomy, instrumentation, techniques, and technical factors were analyzed.ResultsFour phases of vaginal salpingo-oophorectomy were noted: 1) preparation of the operative field, 2) preparation of the adnexal areas, 3) extirpation of the adnexa, and 4) ligation of the ovarian pedicle. Extirpation of the adnexa was performed using two primary techniques: the mesosalpinx-mesovarium and round ligament. However, several variations of these techniques (i.e., single- and double-pedicle, two-stage, preservation of the uteroovarian pedicle) were necessary for the removal of the adnexa in all patients.ConclusionPreparation of the operative field and the adnexa and variations of the customary techniques used for vaginal salpingo-oophorectomy are necessary for the performance of a successful vaginal salpingo-oophorectomy.