CLINICAL ANALYSIS OF PELVISCOPIC CLASSIC INTRAFASCIAL SEMM HYSTERECTOMY

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.