Laparoscopic Subtotal Hysterectomy

Abstract

Hysterectomy was mentioned in Greek manuscripts 2,000 years ago (Baskett 2005). Soranus of Ephesus described a vaginal hysterectomy for a prolapsed gangrenous uterus in the second century AD. The first abdominal hysterectomy was performed by Charles Clay in Manchester in 1844. During the eighteenth century the postoperative mortality of the procedure was over 70 % (Sutton 1997), mainly from haemorrhage and sepsis. The first abdominal total hysterectomy was performed by Dr E H Richardson in Baltimore in 1929. He also advocated the removal of the cervix for the prevention of cervical cancer of the cervical stump, which at the time had a reported incidence of 0.4 % (Johns 1997). However, subtotal abdominal hysterectomy remained the operation of choice for benign uterine disease until 1940 (Sutton 1995), when antibiotics were introduced, because not opening the vaginal vault reduced the risk of infection and thus death.