Initial experience with supracervical laparoscopic hysterectomy and removal of the cervical transformation zone

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Abstract
Objective To assess the feasibility and outcome of laparoscopic supracervical hysterectomy with removal of the cervical transformation zone. Design A prospective clinical study. Setting The department of Gynaecology, Royal Surrey County Hospital, Guildford. Subject Eleven consecutive women who were on the waiting list for abdominal hysterectomy and fulfilled the selection criteria. Intervention Laparoscopic supracervical hysterectomy using a modification of the classical abdominal supracervical hysterectomy technique with removal of the cervical transformation zone. Main outcome measures Operating time, blood loss, duration of hospital stay, time to full recovery and complications. Results All 11 procedures were successfully completed laparoscopically. The mean operating time was 111 min, and mean blood loss was 185 ml. The mean duration of hospital stay was three days, and the mean time to full recovery was 20 days. There were no major complications. Conclusions Laparoscopic supracervical hysterectomy appears to result in a shorter hospital stay and more rapid recovery than total abdominal hysterectomy. This shortened convalescence is of benefit to the patient. The operation appears to be safe when carried out by surgeons experienced in laparoscopic surgery. A randomised comparative study with total abdominal hysterectomy is currently being undertaken.

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