Fig. 3

Classic intrafascial subtotal hysterectomy (CISH). a Multifibroid uterus, b dissection of left adnexa from the uterus with a stapler, c opening of the vesico-uterine space, d preparation of the bladder, e demonstration of the pericervical fascial ring, f transcervical and transuterine resection of a 15-mm tissue cylinder including the “transformation zone around an axial guide rod”, g positioning of a “Roeder loop” as tourniquet to tie the ascending branches of the uterine arteries, h sharp dissection of cervix from the uterine corpus with scissors (or a monopolar loop as LINA Loop or Storz cervical loop), i further cervical dissection, j separation of uterine body from the cervix, k morcellation of the uterus and l irrigation leaving the visceral peritoneum open