Surgical Endoscopy

, Volume 15, Issue 3, pp 286–288

A comparison of laparoscopic supracervical hysterectomy vs laparoscopically assisted vaginal hysterectomy

  • M. P. Milad
  • K. Morrison
  • A. Sokol
  • D. Miller
  • L. Kirkpatrick
Original article



We set out to compare the length of stay, costs, and morbidity associated with laparoscopic supracervical hysterectomy (LSH) with laparoscopically assisted vaginal hysterectomy (LAVH).


We performed a cohort analysis of consecutive patients at a university-based medical center from April 1997 through October 1999.


A total of 145 patients were identified initially; however, 13 cases were excluded because of concomitant procedures (retropubic urethropexy, lymphadenectomy, paravaginal repair). Of the 132 patients included in the study, 27 underwent LSH and 105 underwent LAVH. The two groups were similar with respect to gravidity, parity, uterine weight, and preoperative diagnosis. Patients undergoing LSH had significantly shorter operating times (median, 181 vs 220 min, p = 0.007), briefer hospital stays (median, 1.0 vs 2.0 days, p = 0.0001), and less blood loss (median, 125 vs 400 ml, p = 0.0001). None of the patients submitted to LSH experienced morbidity, as compared with a 13% morbidity rate for LAVH (bladder injury, n = 3; blood loss >1000 ml, n = 7; vaginal cuff hematoma, n = 4; 0% vs 13%; p = 0.04).


Patients undergoing laparoscopic supracervical hysterectomy had shorter operating times, shorter hospital stays, and less morbidity than those who underwent laparoscopically assisted vaginal hysterectomy. The practice of routine cervicectomy at laparoscopic hysterectomy should be reconsidered.

Key words

Cost-benefit analysis Hysterectomy Laparoscopy Vaginal surgery Supracervical hysterectomy Laparoscopically assisted vaginal hysterectomy 


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  1. 1.
    American College of Obstetricians and Gynecologists (ACOG) (1994) Laparoscopically assisted vaginal hysterectomy. ACOG committee opinion no. 146. American College of Obstetricians and Gynecologists, Washington, DC, ppGoogle Scholar
  2. 2.
    Benrubi GI (1988) History of hysterectomy. J Fla Med Assoc 75: 533–538PubMedGoogle Scholar
  3. 3.
    Centers for Disease Control and Prevention Hysterectomy surveillance—United States, 1980-1993. MMWR 46: 1–15Google Scholar
  4. 4.
    Dicker RC, Greenspan JR, Strausss LT, Cowart MR, Scally MJ, Peterson HB, DeStefano F, Rubin GL, Ory W (1982) Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. Am J Obstet Gynecol 144: 841–848PubMedGoogle Scholar
  5. 5.
    Donnez J, Nisolle M, Smets M, Polet R, Bassil S (1997) Laparoscopic supracervical (subtotal) hysterectomy: a first series of 500 cases. Gynaecol Endosc 6: 73–76CrossRefGoogle Scholar
  6. 6.
    Dorsey JH, Holtz PM, Griffiths RI, McGrath MM, Steinberg EP (1996) Costs and charges associated with three alternative techniques of hysterectomy. N Engl J Med 335: 476–482PubMedCrossRefGoogle Scholar
  7. 7.
    Härkki-Siren P, Sjöberg J, Kurki T (1999) Major complications of laparoscopy: a follow-up Finnish study. Obstet Gynecol 94: 94–98PubMedCrossRefGoogle Scholar
  8. 8.
    Kilkku P. Gronroos M (1982) Preoperative electrocoagulation of endocervical mucosa and later carcinoma of the cervical stump. Acta Obstet Gynecol Scand 61: 265–267PubMedCrossRefGoogle Scholar
  9. 9.
    Kresch AJ, Lyons TL, Westland AB, Winer WK, Savage GM (1998) Laparoscopic supracervical hysterectomy with a new disposable morcellator. J Am Assoc Gynecol Laparosc 5: 203–206PubMedCrossRefGoogle Scholar
  10. 10.
    Lyons TL (1993) Laparoscopic supracervical hysterectomy: a comparison of morbidity and mortality results with laparoscopically assisted vaginal hysterectomy. J Reprod Med 38: 763–767PubMedGoogle Scholar
  11. 11.
    Munro MG (1997) Supracervical hysterectomy: a time for reappraisal. Obstet Gynecol 89: 133–137PubMedCrossRefGoogle Scholar
  12. 12.
    Richards SR, Simpkins S (1995) Laparoscopic supracervical hysterectomy versus laparoscopic-assisted vaginal hysterectomy. J Am Assoc Gynecol Laparosc 2: 431–435PubMedCrossRefGoogle Scholar
  13. 13.
    Vara P, Kinnunen O (1951) Total versus subtotal abdominal hysterectomy. Acta Obstet Gynecol Scand 31 (Suppl 5): 1–43Google Scholar
  14. 14.
    Van der Stege JG, Van Beek JJ (1999) Problems related to the cervical stump at follow-up in laparoscopic supracervical hysterectomy. J Soc Laparoendosc Surg 3: 5–7Google Scholar

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • M. P. Milad
    • 1
  • K. Morrison
    • 1
  • A. Sokol
    • 1
  • D. Miller
    • 1
  • L. Kirkpatrick
    • 1
  1. 1.Department of Obstetrics and GynecologyNorthwestern University Medical School and Northwestern Memorial HospitalChicagoUSA

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