title: The classic intrafascial Semm hysterectomy as an alternative to abdominal hysterectomy.
abstract: OBJECTIVE
  To compare the classic intrafascial Semm hysterectomy (CISH) with abdominal hysterectomy.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Community hospital.
  
  
  METHODS
  The first 100 women with intractable uterine bleeding, leiomyomata, and chronic pelvic pain.
  
  
  METHODS
  The CISH procedure, initially with the Endo GIA stapler, but later, electrocoagulation and suture to lower costs and eliminate automatic staple complications.
  
  
  RESULTS
  Operating time for CISH decreased and our ability to remove larger uteri increased as we became more proficient. Complications were limited to one cystotomy and four transfusions. The average hospital stay was 36 hours and most patients were back to normal activity in 3 weeks.
  
  
  CONCLUSIONS
  Our experience suggests that the CISH is organ preserving, is minimally invasive, decreases recovery time, and can be performed in women in whom an open abdominal approach once would have been the only option.
authors.affiliation: Department of Obstetrics and Gynecology, St. Luke's Hospital, Chesterfield, Missouri 63017, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Levine
authors.forename: K
authors.initials: K
authors.lastname: Botney
mesh_terms: D000328:Adult; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D017699:Pelvic Pain / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D017792:Surgical Stapling; D013536:Suture Techniques; D014592:Uterine Hemorrhage / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery