Intrauterine Pressure During Abdominal Hysterectomy

Abstract

Many studies indicate that the process of surgical resection of a tumor may lead to vascular spread of malignant cells. To decrease the pressure in the tumorous mass, and hence the risk of spread, no-touch techniques have been developed and implemented in many fields. In an effort to investigate the degree to which surgical manipulation during hysterectomy altered intrauterine pressure, six patients undergoing hysterectomy for benign conditions were studied. Continuous intrauterine pressure recordings indicate that significant static and transient pressures are created. Pressures observed varied from a high of 314 mm Hg (during cardinal ligament dissection) to a low of 2 mm Hg. There appears to be an increase in the likelihood of elevated pressure as the dissection progresses down the uterus, with an overall average of 43 mm Hg during broad ligament dissection versus 68 mm Hg average during bladder dissection. Pressures seem to fluctuate less as the level of operator experience increases. The significance of these findings in the possible spread of malignant cells is unknown. (J GYNECOL SURG 7:17, 1991)