The classic intrafascial Semm hysterectomy as an alternative to abdominal hysterectomy

Study Objective. To compare the classic intrafascial Semm hysterectomy (CISH) with abdominal hysterectomy. Design. Retrospective analysis. Setting. Community hospital. Patients. The first 100 women with intractable uterine bleeding, leiomyomata, and chronic pelvic pain. Interventions. The CISH procedure, initially with the Endo GIA stapler, but later, electrocoagulation and suture to lower costs and eliminate automatic staple complications. Measurements and Main 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 lour transfusions. The average hospital stay was 36 hours and most patients were back to normal activity in 3 weeks. Conclusion, 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.