Starting from the early 1800s....



Laparotomy serves both diagnostic and therapeutic purposes, allowing surgeons to explore the abdominal cavity, diagnose conditions, and perform necessary interventions (1). Despite advancements in imaging technologies that have improved nonoperative diagnosis, laparotomy remains a critical component of abdominal surgery when imaging is insufficient or when direct intervention is required. Laparotomic hysterectomy is still widely preferred in some indications and  is still relevant and necessary in certain situations. Choice or surgical approach depends on the indications, patient’s preference and surgeon's expertise (2). Here we will discuss basic laparotomic hysterectomy, which is the extrafascial hysterectomy taught in postgraduate training. Radical hysterectomies will not be included. It is a fundamental operation that all gynecologists should learn thoroughly and remains a vital surgical principle despite the rise of laparoscopic techniques. It is indispensable for situations where noninvasive methods are inadequate and for complex cases where open surgery provides a better outcome. The basic surgical principles that underpin laparotomy are shared across various surgical disciplines, emphasizing the importance of sound technique and patient safety (1).