[Vaginal hysterectomy leniens: intrafascial technique].
The appearance of a new intrafascial technique for vaginal hysterectomy serves to remind us that in spite of well-standardized techniques, gynecologists perform this less often than formerly. The described technique is an intrafascial variation of the extrafascial vaginal hysterectomy beginning at the fundus uteri. We mobilize the anterior vaginal wall using Strassmann's incision. The body of the uterus should be delivered through the anterior fornix. Then follows the ligation of the broad ligaments and careful dissection of the fibroareolar space of the posterior cervical wall. The cardinal ligament requires intrafascial clamping and ligation. This technique is simple and avoids injury to the ureters. If this operation is successfully performed, postoperative pain is minimal, and hospitalization could be greatly reduced.
Tapia
Jorge E
JE
Facharzt für Gynäkologie und Geburtshilfe, Steinenvorstadt 33, CH-4051 Basel, Switzerland. tapiajorge@bluewin.ch
D001956:Broad Ligament / Q000601:surgery; D002584:Cervix Uteri / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000295:instrumentation / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control; D008026:Ligation; D010149:Postoperative Pain / Q000517:prevention & control; D013525:Surgical Instruments; D014621:Vagina / Q000601:surgery