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Related Experiment Videos

Histologic features of the CISH procedure

E Alvarez-Rodas1, L Mettler, E Castro

  • 1Department of Obstetrics and Gynecology, Christian Albrechts University of Kiel, Germany.

The Journal of the American Association of Gynecologic Laparoscopists
|November 1, 1994
PubMed
Summary

Classic intrafascial SEMM (serrated-edge macromorcellated) hysterectomy (CISH) is effective via pelviscopy or laparotomy. Histologic analysis confirms complete removal of the squamocolumnar zone in all cases, supporting its role in cervical cancer prevention.

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Area of Science:

  • Gynecologic Surgery
  • Surgical Pathology
  • Oncology

Background:

  • Hysterectomy is a common surgical procedure for various gynecologic conditions.
  • The classic intrafascial SEMM (serrated-edge macromorcellated) hysterectomy (CISH) is a specific surgical technique.
  • Evaluating different surgical approaches and their histologic outcomes is crucial for optimizing patient care.

Purpose of the Study:

  • To compare classic intrafascial SEMM (serrated-edge macromorcellated) hysterectomy (CISH) performed via pelviscopy versus laparotomy.
  • To determine the histologic features and completeness of excision in CISH procedures.

Main Methods:

  • A prospective study involving 253 women requiring hysterectomy.
  • Patients were assigned to CISH by pelviscopy (n=152) or laparotomy (n=101) based on uterine size.

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  • Procedures were performed between September 1991 and December 1993, with uterine leiomyomas being the primary indication.

    • Main Results:

    • Histologic findings correlated with the indications for surgery, with leiomyomas and adenomyosis being most frequent.
    • Complete removal of the squamocolumnar transformation zone was achieved in all cases.
    • Cervical glands were excised in 92% of the procedures.

    Conclusions:

    • Classic intrafascial SEMM (serrated-edge macromorcellated) hysterectomy (CISH) is a viable conservative surgical option.
    • Adequate preoperative screening is essential, as cervical dysplasia is not a contraindication.
    • This procedure may offer protection against certain cervical cancers.