of the uterus (womb) was mentioned as long ago as 5th
century BC by Hippocrates, the father of medicine. However,
apart from sporadic reports, hysterectomy was not practised
until the 19th century. Even then, the mortality of
the procedure was extremely high. It was only after improvements
in antisepsis, anaesthesia and surgical technique to
control haemorrhage in the mid-19th century that hysterectomy
became an accepted procedure.
early hysterectomies were usually done vaginally, but
the introduction of subtotal hysterectomy late in the
19th century meant that abdominal hysterectomy became
dominant; vaginal hysterectomy tended to be restricted
for the management of uterine prolapse.
1988, the first laparoscopic hysterectomy was done
by Harry Reich (USA). Although the procedure has failed
to become popular, one result of this development was
the wider appreciation of the role of vaginal hysterectomy.
Studies showed that compared with the other routes,
vaginal hysterectomy has the shortest operating time,
fastest recovery and lowest cost.
gynaecologists now agree that vaginal hysterectomy is
the optimal route and should be practised whenever possible.