Clinical Study on 300 Cases of Classical Intrafascial SEMM Hysterectomy(CISH)

Cho, J H; Lee, C N; Kim, I H; Kim, K L; Chung, C J; Kim, J W; Shin, M C

Abstract

Laparoscopic hysterectomy, introduced by Reich et al in 1988, has proven to be aneffective alternative to abdominal hysterectomy for women.Several modalities were introduced by some laparoscopists, among which the supracervicalmodality was particularly suitable for laparoscopic surgery because it has someadvantages.The surpracervical hysterectomy requires less dissection of the bladder and the techniqueminimally alters the anatomy and integrity of the pelvic floor and vagina, thereforethe risk of bleeding, surgical injuries to the bladder, ureters and lower intestinal tract weredecreased.These factors may be responsible for the apparently less compromised bladder and sexualFunction and decreased long term morbidity.The purpose of the study described below was to show that laparoscopic supracervicalhysterectomy can be performed safely with minimal morbidity, and to establish the validity ofreplacing the vast majority of traditional abdominal hysterectomies.During the period October, 1992-June, 1996, 300 women underwent Classical IntrafascialSEMM Hysterectomy(CISH) at Cha Hospital, Seoul, Korea and KyungHee BundangCha Hosptial, Seongnam, Korea.Most common age groups were 41~50, and average age of patients was 43.2 years old.Most common parity groups was 2, and average parity was 2.4.Myoma and adenomyosis of uterus were common preoperative surgical indications.Most common uterine size was 8~10 weeks gestational size.The common operation time ranged from 151~180 minutes with a mean of 156 minutes.The common Hgb loss range was 1.5~1.0gm/dl, and average was 0.78gm/dl.The common hospitalization period were 5~6 day with a mean of 5.9days.The complications were 23 cases, among which intra and postoperative bleeding weremost common.