Most hysterectomies should be performed vaginally or laparoscopically

	Tweet

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.”

###

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) published by Elsevier. doi:10.1016/j.jmig.2010.10.001

###

Contact: Francesca Costanzo

215-239-3249
Elsevier Health Sciences

RELATED STORIES:
Pill Among Least Effective Birth Control Methods   70 percent of women use contraceptives during their first sexual encounter   Long-term contraception more effective than pills   Gay couples and women over 40 to get free IVF treatment on NHS   Health secretary urges contraception compromise   Contraceptive ring, patch carry blood clot risks   Reminder Stamp Boosts HPV Vaccination   Study adds to evidence on clot risks of non-oral contraceptives   HPV vaccine completion rate among girls is poor, getting worse   Some ob-gyns cite religious conflicts over care   After IVF, some couples get pregnant without help   Web Tool Offers Map to Menopause   Early Menopause Could Also Mean Early Death   Does soy help cool hot flashes after all?   Caffeine not tied to worsening urinary incontinence

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

No matter what type of hysterectomy is performed, be it robotic, laparoscopic assisted, radical, subtotal, or vaginal, the result is the same: the important lifelong functions of a hormone-responsive reproductive sex organ are permanently gone. Hysterectomies are virtually always an elective procedure, and are not medically warranted 98% of the time.  In most instances, the conditions for which doctors routinely urge hysterectomy (such as fibroids, menstrual variations, prolapse, endometriosis, cervical dysplasia, etc.) are non-threatening.  They may provoke discomfort, may remain symptomless, or may revert to normal spontaneously and require no treatment at all.

posted by Garance on 11/08/2010 at 7:48 am -08:00