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KMID : 0386019960080020110
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Korean Journal of Gynecology Endoscopy and Minimally Invasive Surgery
1996 Volume.8 No. 2 p.110 ~ p.117
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Clinical Evaluation and the Learning Curve of the First One Hundred Classical Intrafascial SEMM Hysterectomy(CISH)
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Abstract
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We analyzed the first one hundred Classical Intrafascial SEMM Hysterectomies(CISH) done by one gynecologist to. study the learning curse, clinical analysis and complications of this technique.
One hundred CISH done for uterine myoma(63%), suspected adenomyosis(14%), menorrhagea(10%) and etc. from November 1994 to March 1996 were studied. No conversion to laparotomy was needed. The size of the uterus ranged from 6 to 16 gestational week and 10 gestational week size was the most common. The operating time ranged from 60 to 330 minutes(mean 152 minutes). The mean operating time was reduced from 230 to 120 minutes. The uterine size and accumulated cases had a positive correlation to operation time and complication. Fifteen complications occurred : one perforation of urinary bladder, three bleeding, two unbalanced displacement of cervical stump and etc.
The operating time was clearly getting short during the first one hundred classical intrafascial SEMM hysterectomy. Technical complications(bladder perforation and intraoperative bleeding) occurred in the begining. Complications such as infection and cervical bleeding do not seem to disappear with experience. Classical intrafascial SEMM hysterectomy appears to be as safe as abdominal or vaginal hysterectomy and the postoperative convalescent time is short. It is clearly an acceptable alternative to hysterectomy technique.
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