A Clinical Study Comparing the Effectiveness and Safety of Three Surgical Pathways for Laparoscopic Total Hysterectomy

Inclusion Criteria: * 18-60 females * Total hysterectomy indications (uterine fibroids, adenomyosis, cervical precancerous lesions, endometrial dysplasia, cervical carcinoma in situ), total hysterectomy is planned * The patients who participated in the study recognized three surgical paths and were willing to accept any of the three at random * Be able to understand the research program and voluntarily participate in the research, and sign the informed consent * Good compliance, able to cooperate with and provide corresponding clinical information * Complete imaging and pathological clinical data; * General condition: ECOG≤1; 0 The activity capacity is completely normal, and there is no difference between the activity capacity and that before the onset of the disease; 1 Can move about freely and engage in light physical activity, including general household or office work, but cannot engage in heavy physical activity. Exclusion Criteria: * asexual life history * The cyst needs to be removed at the same time or there are other vulvar, vaginal, appendix and other lesions, and surgical intervention is required at the same time * Malignant tumors or highly suspected malignant tumors * History of two or more pelvic surgeries, severe pelvic adhesions(triad examination suspected rectal endometriosis, or poor intrauterine mobility) * History of peritoneal dialysis, pelvic radiotherapy, and previous history of pelvic laparoscopic tuberculosis * the uterus is greater than 3 months of pregnancy or the maximum meridian of the uterus is greater than 12cm according to ultrasound (either of the two conditions can be excluded) * Diabetic patients with unsatisfactory blood sugar control * BMI\>30Kg/m2 * History of severe mental illness and brain dysfunction * A history of drug abuse or use * Patients with poor compliance or who are too far away for adequate follow-up