Comparison of Pelviscopic Classic Intrafascial Semm Hysterectomy with Total Laparoscopic Hysterectomy and Laparoscopic-Assisted Vaginal Hysterectomy.

We compared 223 patients, 91 undergoing laparoscopic-assisted vaginal hysterectomy (LAVH), 82 undergoing classic intrafascial Semm hysterectomy (CISH), and 50 undergoing total laparoscopic hysterectomy (TLH) between August 1993 and August 1995. The groups were comparable in age, parity, weight, and previous abdominal surgeries. The mean estimated blood loss associated with LAVH was 1.6 times greater than that with CISH and 1.8 times greater than with TLH. The mean operating time was 174.1 minutes for CISH, 169.4 minutes for TLH, and 142.5 minutes for LAVH. The mean specimen weight was 195.4 g for CISH, 88.1 g for TLH, and 142.5 g for LAVH. The overall complication rates were 3.7%, 5.4%, and 7.7%, respectively, but no major complication occurred with CISH. We suggest that CISH is safer, more effective, and less damaging than the other procedures, and associated with lower morbidity in managing benign uterine disease.