Introduction of Laparoscopic Hysterectomy Approach: Decreasing the Abdominal Hysterectomy Approach or Replacing Vaginal Hysterectomy
Journal Title: Surgical Research – Open Journal - Year 2015, Vol 2, Issue 1
Abstract
Background: It has been noted in the medical literature that abdominal hysterectomy rates continue to be over 66%, with less than one-third of hysterectomies performed via minimally invasive approaches despite the rapidity of recovery. We compared trends in hysterectomy routes for the years 2000 and 2010 at our institution. Methods: Expedited IRB approval was obtained for a retrospective chart review of all hysterectomies performed during 2000 and 2010. Medical records were abstracted for basic demographics, including age, Body Mass Index (BMI), uterine size (grams), and route of hysterectomy (laparoscopic, vaginal, laparotomy). Laparoscopic approaches included Total Laparoscopic Hysterectomy (TLH), Laparoscopic Supracervical Hysterectomy (LSH), Laparoscopy Assisted Vaginal Hysterectomy (LAVH), and Da Vinci robotic hysterectomy. Standard statistical analysis was performed using JMP statistical programming. Results: No differences were found between mean age and racial distribution in the years analyzed. In 2000 and 2010, 50% of hysterectomies were performed using minimally invasive techniques. In 2000, 47% were performed via the vaginal route whereas in 2010, 47.7% were performed via laparoscopy. When patients were stratified by weight class, obese women (BMI>30) had a statistically significant greater number of hysterectomies performed via the abdominal route when compared to normal weight women; this was independent of uterine weight. African-American women were also found more likely to have an abdominal hysterectomy, but once controlled for uterine weight, this difference dissipated. Conclusions: At our institution, 50% of hysterectomies were performed using minimally invasive techniques in both 2000 and 2010, with laparoscopic approaches essentially replacing vaginal hysterectomies by 2010 without affecting abdominal hysterectomy rates. Minimally invasive approaches continue to lag in obese women.
Authors and Affiliations
Lisa Beth Spiryda
Keywords
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- EP ID EP558183
- DOI 10.17140/SROJ-2-107
- Views 135
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