Most hysterectomies should be performed vaginally or laparoscopically

Nov 07, 2010

Approximately 600,000 hysterectomies are performed in the United States annually to treat benign disorders of the pelvis. More than two-thirds are performed through an abdominal incision. In an evidence-based position statement published online today in The Journal of Minimally Invasive Gynecology, the AAGL, a medical specialty society of over 5,000 gynecologic surgeons, advocates the practice of performing these procedures vaginally or laparoscopically in a minimally invasive manner, thus reducing morbidity and facilitating a faster recovery period.

Vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) are associated with low surgical risks and can be performed with a short hospital stay or in many instances as an outpatient procedure. Abdominal hysterectomy (AH) requires a relatively large abdominal incision and is associated with a number of disadvantages largely related to abdominal wound infections, relatively prolonged institutional stay, and delayed return to normal activities.

"When procedures are required to treat gynecologic disorders, the AAGL is committed to the principles of informed patient choice and provision of minimally invasive options," commented Franklin D. Loffer, MD, Executive Vice President/Medical Director of the AAGL. "When hysterectomy is necessary, the demonstrated safety, efficacy, and cost-effectiveness of VH and LH mandate that they be the procedures of choice. When hysterectomy is performed without a laparotomy, early institutional discharge is feasible and safe, in many cases within the first 24 hours."

Clinical situations once considered as contraindications to LH are obesity and a previous cesarean section. However, evidence suggests that, aside from longer operative times, safety and efficacy are similar for obese and non-obese patients.

In conclusion the position statement asserts that "It is the position of the AAGL that most hysterectomies for benign disease should be performed either vaginally or laparoscopically and that continued efforts should be taken to facilitate these approaches. Surgeons without the requisite training and skills required for the safe performance of VH or LH should enlist the aid of colleagues who do or should refer patients requiring hysterectomy to such individuals for their surgical care."

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

More information: The article is "Route of Hysterectomy to Treat Benign Uterine Disease," a position statement by the AAGL. Currently published as an Article in Press, it will appear in the Journal of Minimally Invasive Gynecology, Volume 18, Issue 1 (January/February 2011). doi:10.1016/j.jmig.2010.10.001

add to favorites email to friend print save as pdf

Related Stories

Researchers find decrease in hysterectomy complications

Sep 17, 2008

UC Davis researchers who studied hospital discharge records for nearly 650,000 California women over a 13-year period have found that complications from hysterectomies have significantly declined. The study appears in the ...

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 0

More news stories

UAE reports 12 new cases of MERS

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

NASA's space station Robonaut finally getting legs

Robonaut, the first out-of-this-world humanoid, is finally getting its space legs. For three years, Robonaut has had to manage from the waist up. This new pair of legs means the experimental robot—now stuck ...