The Doderlein Vaginal Hysterectomy: A Useful Approach for the Neophyte Vaginal Surgeon

Training in vaginal hysterectomy and pelvic reconstructive surgery has not kept pace with advances in other areas of obstetrics and gynecology. A paucity of senior and talented teachers of vaginal surgery is one of the major reasons for this decline. In this article, we discuss the merits of the technique of vaginal hysterectomy by anterior delivery of the uterine corpus originally described by Doderlein and Kronig in 1906. The authors use this technique to initiate junior residents to vaginal surgery. Advantages to the novice are early entry into the peritoneal cavity anteriorly, easy retraction of the bladder out of the surgical field, less blood loss because of early ligation of the major blood supply to the uterus, and no incision into the posterior vagina until the uterus is finally removed. We believe that this surgical procedure has amply demonstrated its usefulness and should be given wider exposure in obstetric and gynecologic residency programs. (J GYNECOL SURG 6:123, 1990)