子宮膣上部切断術後の子宮頸部脱に対し腹腔鏡併用下に頸部摘出術を行なった１例

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Introduction: Although supracervical hysterectomy is performed less frequently than total hysterectomy, preservation of the cervix is still focused on in consideration of pelvic floor function and sexual function. Robot-assisted sacrocolpopexy is becoming more popular for pelvic organ prolapse, and the use of supracervical hysterectomy may increase in future. Perioperative complications such as heavy bleeding and ileus occur at high rates in residual cervix excision after supracervical hysterectomy. In this report, we present a case of a patient with prolapse in the residual cervix after supracervical hysterectomy who underwent a cervix excision with laparoscopy.

Case presentation: The patient was a 78-year-old woman who underwent supracervical hysterectomy at the time of cesarean section at the age of 24. She presented to our department because of prolapse of the residual cervix. Concerned about intra-abdominal adhesions, we performed a vaginal procedure under laparoscopic observation to detach the adhesions and avoid damage to the surrounding organs. The patient had no significant perioperative complications.

Conclusions: In this case, the use of a laparoscope for residual cervix excision allowed us to observe the adhesion and avoid organ damage. The laparoscope may generally be useful in preventing intraoperative hemorrhage and ileus. It is important to inform the patient preoperatively of the possibility of residual cervical lesions and the complications associated with adhesions when cervical excision is necessary as a part of the informed consent for supracervical hysterectomy. The use of laparoscopy for retained cervix excision is suggested to be useful.