INTRAFASCIAL VAGINAL HYSTERECTOMY (IVH) - A NEW TECHNIQUE FOR MINIMALLY INVASIVE SURGERY

Intrafascial vaginal hysterectomy (IVH) is a technique which was intro duced by Semm in 1993. We conducted a retrospective chart review on th e first 25 cases of IVH, performed in the Department of Obstetrics and Gynecology of the University of Kiel; these were carried out between June 1993 and January 1994. Using a cervix coring device, calibrated u terine resection tool (CURT), we aim to preserve the pelvic urodiaphra gm structures, with particular regard to anatomical relations, blood s upply and neural function. In this way full sexual function can be ret ained, and those patients who require a hysterectomy can have a better quality of life. The patients had an age range of 32-74 years with a mean of 47.4 years. The main indications for surgery presented were th erapy-resistant uterine bleeding (56%) and myomas with menstrual abnor malities (52%). The mean estimated blood loss associated with IVH was 219.6 ml and the mean operative time was 84.4 min. There were three co mplications (12%), promptly identified and treated without further pro blems, Histological studies on the cored-out cervix specimens showed o nly three cases (12%) demonstrating glands reaching the edge. With thi s minimally invasive technique we observed several advantages to the p atient, achieved without any added difficulties to the surgical proced ure itself.