NO. This retrospective study from Brigham and Women’s Hospital found that a transition from a preponderance of abdominal hysterectomies to a majority of minimally invasive hysterectomies did not increase the mean total cost. The transition was also associated with a lower rate of procedure-related complications.
Jonsdottir GM, Jorgensen S, Cohen SL, et al. Increasing minimally invasive hysterectomy: effect on cost and complications. Obstet Gynecol. 2011;117(5):1142–1149.
EXPERT COMMENTARY
Charles E. Miller, MD Clinical Associate Professor of Obstetrics and Gynecology, University of Illinois at Chicago; Director of Minimally Invasive Gynecologic Surgery, Advocate Lutheran General Hospital, Park Ridge, III.; and Director, AAGL/SRS Fellowship in Minimally Invasive Gynecologic Surgery, Advocate Lutheran General Hospital, Park Ridge, III. Dr. Miller is President of the International Society for Gynecologic Endoscopy.
WHAT THIS EVIDENCE MEANS FOR PRACTICE
I agree with a recent position statement from the AAGL, which concludes that most hysterectomies for benign indications should utilize the vaginal or laparoscopic approach.7 AAGL also recommends that efforts to facilitate these approaches continue. Surgeons who lack the requisite skills and training should seek assistance from expert colleagues or refer the patient to a surgeon with such expertise.—CHARLES E. MILLER, MD
