The classic intrafascial Semm hysterectomy as an alternative to abdominal hysterectomy.

STUDY OBJECTIVE

To compare the classic intrafascial Semm hysterectomy (CISH) with abdominal hysterectomy.

DESIGN

Retrospective analysis.

SETTING

Community hospital.

PATIENTS

The first 100 women with intractable uterine bleeding, leiomyomata, and chronic pelvic pain.

INTERVENTIONS

The CISH procedure, initially with the Endo GIA stapler, but later, electrocoagulation and suture to lower costs and eliminate automatic staple complications.

MEASUREMENTS AND MAIN RESULTS

Operating time for CISH decreased and our ability to remove larger uteri increased as we became more proficient. Complications were limited to one cystotomy and four transfusions. The average hospital stay was 36 hours and most patients were back to normal activity in 3 weeks.

CONCLUSION

Our experience suggests that the CISH is organ preserving, is minimally invasive, decreases recovery time, and can be performed in women in whom an open abdominal approach once would have been the only option.