The Loss of Vaginal Hysterectomy

AbstractPurpose of ReviewThe purpose of this review is to provide an update on evidence to support primary use of the minimally invasive approach provided by vaginal hysterectomy in benign conditions that meet criteria for removal of the uterus. This paper will also serve to discuss why the vaginal approach to hysterectomy has decreased over the last decade and to provide observations and solutions to this problem.Recent FindingsRecent findings continue to support vaginal hysterectomy as the preferred route for hysterectomy as endorsed by position statements by the American College of Obstetrics and Gynecology, the American Association of Gynecologic Laparoscopists, the Society of Gynecologic Surgeons, and in a position statement from the Cochrane Review. Even with this evidence and support from national organizations, the number of endoscopic procedures continues to rise, while vaginal hysterectomy rates drop. Evidence suggests that this may be related to an overall decrease in the number of hysterectomies performed and thus inadequate training and therefore a failure to follow an evidence-based approach to hysterectomy. Changes in training including the increased use of simulation and maximizing exposure to surgical cases for those interested in gynecologic surgical subspecialties by residency tracks are two innovations aimed at improving surgical proficiency.SummaryAs the least invasive and lowest cost route for hysterectomy, vaginal hysterectomy continues to be replaced b...
Source: Current Obstetrics and Gynecology Reports - Category: OBGYN Source Type: research