I read with interest the work of Candani et al. The authors reported that planned adnexectomies were done in 100% of the laparoscopic procedures vs 73% of the vaginal. The increasing experiences in laparoscopic surgeries had led these and other authors to suggest that laparoscopic hysterectomy should be preferred over vaginal hysterectomy, because difficult transvaginal oophorectomies are among the potential benefits of the laparoscopy approach.

We suggest a different approach, which is to proceed with a vaginal hysterectomy, and, when ovarian descent is absent or adhesions are found during surgery, then it is suggested to carry out a hybrid culdolaparoscopy oophorectomy.

The technique places a 12 mm diameter, 15 cm length multifunctional cannula via the circular colpotomy after the uterus is removed. With proper vaginal tamponade, a pneumoperitoneum is developed. A 10 mm diameter, 30° angle laparoscope is introduced. Under culdoscopic surveillance 3 or 5 mm abdominal ports are inserted to aid in the oophorectomies. The culdolaparoscopy oophorectomy should be considered as an optional technique that allows for the removal of planned oophorectomies up to 100% in vaginal hysterectomies.