Clampless vaginal hysterectomy in women with nonprolapse: evaluation of a new technique

Background: Vaginal hysterectomy is the least invasive method of removal of uterus.Most of hysterectomies can be performed vaginally. The lower rate of vaginal hysterectomy is not only due to the relative contraindications to the vaginal route of hysterectomybut also due to the technical barriers in the mind of most surgeons to deal with inadequateaccessibility, poor visibility and effective hemostasis even after considerable experiences.I aim to evaluate a clampless technique for vaginal hysterectomy in comparison to thestandard technique in patients without genital prolapsed.Methods:$IWHUHWKLFDODSSURYDOZRPHQDGPLWWHGWR*QHFRORJ'HSDUWPHQW0DQVXUD8QLYHUVLW+RVSLWDOIRUKVWHUHFWRPIRUEHQLJQOHVLRQVGXULQJWKHSHULRGIURP0D WR1RYHPEHUKDGEHHQGLYLGHGWRJURXSV JURXS $ FRPSULVHGZRPHQin whom a clampless technique used, and group (B) comprised 25 women in whom thestandard technique using clamps has been used.Results: The study comprised 46 women assigned for vaginal hysterectomy for benignindication mostly abnormal uterine bleeding. They were divided randomly into 2 groups;group- A (21 women), for whom a clampless vaginal hysterectomy was performed, whilethe other group- B (25 women) used as a control (standard) group for whom the standardtechnique for vaginal hysterectomy was performed.7KHUHZHUHQRVWDWLVWLFDOOVLJQL¿FDQWGLIIHUHQFHEHWZHHQERWKJURXSVUHJDUGLQJWKHGHmographic data (p- value > 0. 05) in all. The mean age for both groups was 51.7 and 52.0years respectively. The mean gravidity was 4.14 and 4.92 respectively. Mean parity forgroup A was 3.47 and that for group B was 3.16. T he BMI was 29.28 kg/m2 for group Awhile 29.16 kg/m2 for group B.1RVWDWLVWLFDOOVLJQL¿FDQWGLIIHUHQFHVZHUHIRXQGEHWZHHQERWKJURXSVDVUHJDUGVWKHpreoperative uterine volumes 232.8 mL vs. 213.0 mL respectively. The mean operativetime (in minutes) for vaginal hysterectomy in group A was 92.3±7.45 while it was 94.0±ZLWKQRVLJQL¿FDQWGLIIHUHQFHEHWZHHQERWKJURXSV7KHPHDQYDOXHVRISUHDQGSRVWRSHUDWLYHKHPRJORELQFRQFHQWUDWLRQVZHUHQRWVLJQL¿FDQWOGLIIHUHQWLQWKHWZRVWXGgroups (Figure 1).Conclusion: Finally we can conclude that clampless vaginal hysterectomy is a techniquethat can be practiced as alternative to traditional technique using clamps.Keywords: clampless, vaginal, hysterectomy