Multifire Endo GIA를 이용한 골반경 자궁적출술(CISH) 의 임상적고찰

Abstract

Twenty patients underwent pelviscopic classical intrafascial SEMM hysterectomies (CISH) using multifire Endo GIA from March 1994 to December 1994 at the Department of Obstetrics and Gynecology Keimyung University. CISH method is pelviscopic supracervical hysterectomy with transvaginal cylindrical coring out of the cervical tissue using CURT. The advantages of the CISH method using CURT may be the preservation of the pelvic floor organ and minimally invasive surgery. Our method which is multifire Endo GIA to transect the infundibulopelvic ligament, makes facilitate the operating procedure and reduce the blood loss. the mean age of the patients was 41 years old. the indications of the surgery were uterine myoma(12 cases 60%), adenomyosis(8cases 40%). In the size of uteri, 8 gestational week-sized were 7 cases (35%), 10 gestational week-sized were 9 case(45%), 12 gestational week-sized were 3 cases (15%), 14 gestational week-sized was 1 case (5%). The mean hospitalization was 5.1 days and the mean estimated blood loss was 1.6gm/dl hemoglobin. the mean operating time was 186 minutes. Postoperative complications were as follows ; cervical stump hematoma(1), cone site hemorrhage(2), trocar puncture site hematoma(2). In conclusion, CISH operation using miltifire Endo GIA not only makes the procedure safer for the patients but also facilitates surgery and reduces operating time of conventional CISH operation. The trauma to the patients is minimal, and organ preservation and fundction are optimal.