Subtotal vaginal hysterectomy

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Abstract
Summary Five women requiring hysterectomy for benign indications and with normal cervical cytology, underwent the new procedure of subtotal (supracervical) vaginal hysterectomy combined with salpingo-oophorectomy in two cases. Using the Doderlein-Kronig approach, an anterior colpotomy was made and the uterine fundus delivered into the vagina. The ovarian and uterine pedicles were ligated in turn before amputating the uterine body from the cervix. The cervical incision was then repaired and the vaginal incision closed. Operative times ranged from 35 to 150 min, one procedure being prolonged by difficulty with bladder dissection following two previous Caesarean sections. Subtotal vaginal hysterectomy is an alternative to abdominal and laparoscopic subtotal hysterectomy, which avoids two of the disadvantages of these techniques, the need for abdominal incisions and the need for laparoscopic expertise.

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