Laparoscopic Subtotal Hysterectomy: Evidence and Techniques

Association of the U.S. Food and Drug Administration Morcellation Warning With Rates of Minimally Invasive Hysterectomy and Myomectomy

“…If we find that the overall rate of minimally invasive surgery remains the same and there is only a decrease in minimally invasive supracervical hysterectomies, there is little lost for patients; data have not shown significant clinical benefit for laparoscopic supracervical hysterectomies compared with total laparoscopic hysterectomies to begin with. 13,14 However, our data show a large percentage of the minimally invasive supracervical hysterectomies became open cases. Analysis of nononcologist hysterectomy data (gynecologic oncologists did not perform any supracervical hysterectomies) shows a 12.3% decrease (236/1,092 down to 95/1,023) in the overall proportion of supracervical hysterectomies after the FDA announcement with only a 6.5% rise in total laparoscopic and robotic-assisted hysterectomies (585/1,092 up to 621/1,023) to account for both the decrease in supracervical hysterectomies and a 3.5% decrease in vaginal hysterectomies.…”

Supracervical hysterectomy by laparoendoscopic single site surgery

“…The postoperative complication rate observed in this study is substantial. However, it does not differ to the postoperative complication rates observed by conventional laparoscopy (up to 19 % of cases according to a recent review) [21]. Half of the complications that required a second surgical intervention were bleeding coming from the endocervix.…”

Pain reduction after total laparoscopic hysterectomy and laparoscopic supracervical hysterectomy among women with dysmenorrhoea: a randomised controlled trial

“…A large high‐quality RCT comparing different methods of hysterectomies is costly and time‐consuming to perform and they are therefore rarely conducted . Consequently, there is a shortage of additional RCTs comparing methods of minimal invasive hysterectomies . A large prospective non‐randomised trial of 1952 women has reported results in favour of LSH in peri‐ and postoperative outcomes and complications compared with TLH .…”

“…The majority of hysterectomies incorporate removal of the cervix, but the rate of supracervical (or subtotal) hysterectomy has increased in the last decades . Supracervical hysterectomy is mainly performed in premenopausal women with benign conditions and no previous history of cervical intraepithelial neoplasia (CIN).…”

“…A risk of persistent pain and repeated surgery after LSH has also been reported such that several authors have stated that supracervical hysterectomy should not be performed in women with endometriosis, pelvic pain or dysmenorrhoea . In contrast, other gynaecologists conclude that endometriosis or pelvic pain should not be contraindications for performing supracervical hysterectomy, unless leaving the cervix compromises the removal of endometriosis .…”