Re: A recent study by economists on the impact of home births on infant outcomes confuses the debate on home birth

Abstract

The authors seem to have misunderstood our new surgical technique. It goes beyond a simple retrograde hysterectomy, as it mimics the en bloc resection of a pelvic malignancy for culde-sac disease in one contiguous sample. We widely open the retroperitoneum, enabling the identification of noble structures to then mobilise ureters laterally. The exposure of the cul-de-sac and dissection of critical areas are facilitated by the placement of a sponge stick into the vagina and lower uterine segment elevation. After uterine devascularisation, the development of vesicouterine space allows the specimen to be drawn out of the pelvis and an assessment of the need for partial bladder resection is made. & References