Modified Classic Intrafascial Supracervical Hysterectomy: The comparison with conventional method

Lee, Eun Sil; Lee, Sang Hoon; Kim, Dong Ho

Abstract

OBJECTIVE
To introduce the technical aspects and advantages of a new classic intrafascial supracervical hysterectomy (CISH) technique over the conventional technique.
METHODS
The charts of two hundred women who underwent conventional CISH technique (100 cases) between March 2000 and September 2000, or the new CISH technique (100 cases) between May 2002 and November 2002 were reviewed regarding patient characteristics, indications, uterine weight, estimated blood loss, operating time, and hemoglobin change. Cases with a very large uterus (over 500 g of weight), severe adhesions, and other complications, which required a longer operating time, were excluded and this study compared the most recent patient's data for both procedures, since the surgeon's experience and surgical technique will improve with practice.
RESULTS
The women who underwent the new CISH had significantly shorter operating time as compared with the conventional method (106.7 vs 90.4 min). Although there was no significant difference in the estimated blood loss, the drop of Hb, which is an objective sign of blood loss, was significantly smaller using the new CISH technique than using the conventional CISH technique (1.98 vs 1.64 g/dL).
CONCLUSION
The new CISH technique is safer, more convenient with less blood loss and shorter op time than the conventional technique, especially when the uterus is markedly enlarged by a large myoma, the ovarian ligament is too short, or the ovary and uterus are very closely adherent.