What is a practical target for hysterectomy approaches other than abdominal?

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A high percentage of hysterectomies—70% or more—should employ approaches other than abdominal, according to 42% of OBG Management readers who answered our Instant Poll Online. Some commented that it’s time to target an even higher rate. Most studies show that, compared with abdominal hysterectomy, laparoscopic and vaginal hysterectomies entail shorter hospitalization and recovery, and less postop pain. On the other hand, laparoscopic hysterectomy takes longer, uses more equipment (which adds expense), and requires specialized surgical skills.

  • As one who has performed more than 100 laparoscopic supracervical hysterectomies, I’m glad to see the interest in this procedure growing
  • All studies show higher complication rates [than a few more urinary tract injuries]…you gung-ho cowboys need to be honest about this
  • I have performed more than 100 laparoscopic supracervical hysterectomies within the last year…with no complications
  • More than 90% of hysterectomies should be done vaginally
  • At least 90% target, if for other than oncology reasons
  • 98% should be the target rate for nonabdominal hysterectomy

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