Vaginal hysterectomy: the use of a self-retaining retractor

This report concerns the indications, technique, and safety of vaginal hysterectomy among 213 women. It further examines the comparative risks of complications and costs between 107 patients whose operations were performed with the use of the new retractor during the 5-year period ended June 1991 and 106 other patients whose surgeries were done during 4 preceding years when the retractor was not available. The selected characteristics of the patients undergoing vaginal hysterectomy in the two groups were largely similar. When the retractor was used, suturing the cuff and pedicles was easier, as the retractor facilitated good exposure and better visibility. In no case was there any injury or the need for transfusion. Of 7 patients with morbidity, 1 had no demonstrable cause, 3 had urinary tract infection, and 3 had cuff cellulitis of which one progressed into abscess requiring transvaginal drainage 6 days postoperation. My experience with 107 vaginal hysterectomies using the self-retaining retractor demonstrates that the retractor was instrumental in significantly reducing operative time, blood loss, and morbidity.