A. Hysterectomy - Historical Perspective

The following is a chronologic historical perspective of significant events concerning hysterectomy:

SORANUS of Ephesus (2nd century AD)

First hysterectomy for prolapse, gangrenous uterus

Giaccorne BERENGARIO DaCapi (1480-1550)

First reference to altered sex life following vaginal hysterectomy for gangrenous uterus

18th CENTURY

Reported mortality rate 90%. Most doctors were of the opinion it was unlikely that one could survive a hysterectomy

RECAMIER (1774-1852)

1824: First successful vaginal hysterectomy for cancer of the cervix

SEMMELWEIS (1818-1865) and LISTER (1827-1912)

Antiseptic techniques reduced morbidity and mortality

SIMPSON (London, England)

1847: Introduction of chloroform anesthesia improved techniques for both abdominal and vaginal hysterectomy. However, chloroform was toxic, operations ideally were not supposed to exceed one hour. All techniques were designed out of necessity to be quick

HEATH (Manchester, England)

1843: First successful subtotal hysterectomy

BURNHAM (Lowell,MA-USA)

15 cases of successful abdominal hysterectomy

PORO (Milan, Italy)

1876: First hysterectomy on gravid uterus

FREUND (Breslau, Germany)

30 Jan. 1878: First refined standardized reproducible "simple" abdominal hysterectomy

SCHAUTA and his student WERTHEIM (Vienna, Austria)

16 Nov.1898: First radical hysterectomy for cancer of the uterus

From 1900 to the 1940s in the United States subtotal hysterectomy was most often performed. The technique was considered simpler, safer, and associated with lower morbidity and less blood loss than total abdominal hysterectomy. During the 1940s and 1950s a great debate ensued at national and international meetings about the wisdom of removing the cervix at the time of hysterectomy as prophylaxis against cervical cancer. A number of studies reported an incidence of cervical stump cancer that ranged from 0.3% to as high as 10.7%.

PALMER (Paris, France)

1940s: Introduction of laparoscopy

RAURAMO, ALDRIDGE and MEREDITH

1964: Proponents of subtotal hysterectomy. They tried to resolve the dilemma of cervical stump cancer by excising the cervical canal at supracervical hysterectomy, but the operation was fraught with complications

RIES

1961: had already recommended transvaginal electroconization of the cervix but had little success because of bleeding and infection

FRANGENHEIM (Konstanz, Germany)

1950s/1960s: Minimally invasive, organ preserving endoscopic surgery replaces laparotomy

SEMM (Kiel, Germany)

1970s/1980s: Marked advance with operative laparoscopy (pelviscopy)

REICH (Kingston, PA-USA)

1989: First laparoscopic-assisted vaginal hysterectomy

SEMM (Kiel, Germany)

7 Sept.1991: First C*I*S*H* (Classic Intrafascial S.E.M.M. Hysterectomy)

VIETZ and AHN (Westminster, MD-USA)

26 Dec.1991: First C*I*S*H* in the USA

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September 1997