Clinical analysis of pelviscopic classic intrafascial Semm hysterectomy.

STUDY OBJECTIVE

To evaluate the efficacy of pelviscopic classic intrafascial Semm hysterectomy (CISH).

DESIGN

Review of hospital records of 90 women undergoing pelviscopic CISH between April 1993 and June 1994.

SETTING

Department of Obstetrics and Gynecology at a university teaching hospital.

PATIENTS

Sequential sample of 90 women undergoing pelviscopic intrafascial hysterectomies.

INTERVENTIONS

All of the hysterectomy procedures were performed in the classic manner with grasping forceps, scissors, ligatures, and sutures. No lasers, electrocoagulation, or stapling devices were used.

MEASUREMENTS AND MAIN RESULTS

Indications, associated procedures, surgical outcomes, and complications were analyzed. The most common surgical indication was leiomyomata uteri. No major complications occurred even in patients who had extremely large leiomyomata. The mean uterine weight was 207.49 +/- 104.9 g. The average operating time (169.89 +/- 56.19 min) was consistent with that of other methods. Blood loss (160 +/- 182 ml) was lower than during conventional abdominal hysterectomy. No procedure was converted to laparotomy.

CONCLUSIONS

Pelviscopic CISH is truly a minimally invasive and organ-preserving surgery, and in our study was associated with significantly low morbidity and no major complications. Pelvic floor support is maintained and the ureters are not in danger. Coring out the cervix with the calibrated uterine resection tool may prevent the development of cervical cancer. Therefore, we think that CISH may be an acceptable technique for benign uterine disease.