title: Vaginal hysterectomy without ligation of the ligaments of the cervix uteri.
abstract: An operative procedure for vaginal hysterectomy is reported. The procedure is performed without ligation of the paracervical ligaments to simplify and avoid ureteral injury. However, a portion of the cardinal ligament is ligated before peritoneal closure. In a study from 1955 to 1987, of 9,230 patients requiring vaginal hysterectomy, blood loss was less than 300 milliliters with this procedure in 83 per cent of the patients. Operative complications, such as bladder injury, occurred in 66 patients or 0.7 per cent. Ureteral injury occurred in only three patients or 0.03 per cent. From 1972 to 1987, only five of 2,460 patients (0.02 per cent) required postoperative hemostasis. These data indicate that vaginal hysterectomy without ligation of the paracervical ligaments is a safe and convenient operative method with fewer complications.
authors.affiliation: Department of Obstetrics and Gynecology, Sapporo Medical College, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kudo
authors.forename: O
authors.initials: O
authors.lastname: Yamauchi
authors.forename: T
authors.initials: T
authors.lastname: Okazaki
authors.forename: S
authors.initials: S
authors.lastname: Sagae
authors.forename: E
authors.initials: E
authors.lastname: Ito
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
mesh_terms: D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods*; D007431:Intraoperative Complications; D009929:Organ Size; D011183:Postoperative Complications; D014599:Uterus / Q000473:pathology