Dh. Kim et al., CLINICAL ANALYSIS OF PELVISCOPIC CLASSIC INTRAFASCIAL SEMM HYSTERECTOMY, The Journal of the American Association of Gynecologic Laparoscopists, 2(3), 1995, pp. 289-297
Study Objective. To evaluate the efficacy of pelviscopic classic intra
fascial Semm hysterectomy (CISH). Design. Review of hospital records o
f 90 women undergoing pelviscopic CISH between April 1993 and June 199
4. Setting. Department of Obstetrics and Gynecology at a university te
aching hospital. Patients. Sequential sample of 90 women undergoing pe
lviscopic intrafascial hysterectomies. Interventions. All of the hyste
rectomy procedures were performed in the classic manner with grasping
forceps, scissors, ligatures, and sutures. No lasers, electrocoagulati
on, or stapling devices were used. Measurements and Main Results. Indi
cations, associated procedures, surgical outcomes, and complications w
ere analyzed. The most common surgical indication was leiomyomata uter
i. 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 tha
t of other methods. Blood loss (160 +/- 182 ml) was lower than during
conventional abdominal hysterectomy. No procedure was converted to lap
arotomy. Conclusions. Pelviscopic CISH is truly a minimally invasive a
nd organ-preserving surgery, and in our study was associated with sign
ificantly low morbidity and no major complications. Pelvic floor suppo
rt is maintained and the ureters are not in danger. Goring out the cer
vix with the calibrated uterine resection tool may prevent the develop
ment of cervical cancer. Therefore, we think that CISH may be an accep
table technique for benign uterine disease.