437 classic intrafascial supracervical hysterectomies in 8 years.
OBJECTIVE
To report technical aspects and practical long-term experience with classic intrafascial supracervical hysterectomy (CISH).


METHODS
Retrospective evaluation (Canadian Task Force Classification II-2).


METHODS
Local community hospital in rural northwest Alabama.


METHODS
Four hundred thirty-seven women.


METHODS
The procedure was performed as described originally but with slight modifications (vaginal manipulator, ETS stapler).


RESULTS
Follow-up was 44.7 months (range 3-97 mo). Average operating time was 1 hour 10 minutes (range 46 min-6 hrs, 10 min), average blood loss was 68 ml (range 10-765 ml), average length of hospital stay was 22 hours (range 10 hrs-5 days), and average return to work was 14 days (range 3-28 days). Complications were 11 bleeding cervices (7 occurring within 21 days after surgery, and 4 between 2 and 4 yrs after surgery), 1 case of uterine artery bleeding, 1 ileus, 1 pelvic hematoma, and 5 mucoceles between 2 and 27 months postoperatively. There were three conversions, one because of morbid obesity (185 kg) and two because of large uterus:pelvis ratio.


CONCLUSIONS
CISH leaves the pelvic floor intact, has short recuperation and high patient satisfaction, and is cost effective at a low complication rate. It is an advanced laparoscopic procedure, is initially technically challenging, and has a learning curve.
Morrison
J E
JE
Department of Surgery, Fayette Medical Center, 1035 Temple Avenue North, Fayette, AL 35555, USA.
Jacobs
V R
VR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery