title: A report on more than 10,000 vaginal hysterectomies performed without ligation of the paracervical ligaments.
abstract: OBJECTIVE
  To review 10,016 cases of total vaginal hysterectomy (TVH) performed in our department by a method without ligation of the paracervical ligaments.
  
  
  METHODS
  From 1955 to 1997, a total of 10,016 TVHs without ligation of the paracervical ligaments were performed at the Department of Obstetrics and Gynecology, Sapporo Medical University Hospital.
  
  
  RESULTS
  Of all 22,509 gynecological operations, 44.5% were TVHs, and 8.7% were total abdominal hysterectomies (TAHs). The operative time of our TVHs ranged from 31-60 minutes in 44.1% of the cases, and from 61-90 minutes in 35.3% of the cases. Blood loss was less than 300 ml in 85% of the cases. Abdominal conversion from the vaginal approach occurred in 110 cases (1%). Operative complications also occurred only in 0.7% (69) of the cases.
  
  
  CONCLUSIONS
  TVH without ligation of the paracervical ligaments is a safe and convenient method that has very few complications and that can be utilized by many gynecologists.
authors.affiliation: Department of Obstetrics and Gynecology, Sapporo Medical University, School of Medicine, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kudo
authors.forename: S
authors.initials: S
authors.lastname: Sagae
authors.forename: E
authors.initials: E
authors.lastname: Itoh
authors.forename: O
authors.initials: O
authors.lastname: Hayakawa
authors.forename: M
authors.initials: M
authors.lastname: Koizumi
authors.forename: S
authors.initials: S
authors.lastname: Ishioka
mesh_terms: D016063:Blood Loss, Surgical; D002584:Cervix Uteri; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000379:methods* / Q000706:statistics & numerical data; D008022:Ligaments / Q000601:surgery*; D008026:Ligation; D009929:Organ Size; D014599:Uterus / Q000473:pathology