In the United States, over 600,000 women undergo a hysterectomy (removal
of the uterus) each year, and the majority are performed through a large
abdominal incision. Ironically, the inverse is the practice in most European
countries where vaginal and laparoscopic hysterectomies predominate.
According to multiple medical studies, these less invasive routes not only
lessen risk and expedite a patient’s recovery, but also are appropriate
in the majority of procedures for benign disease. An article in this month’s
Journal of Obstetrics & Gynecology reported trends in hysterectomy rates and routes in California from 1991
2004. Despite a decrease by the end of this period, 55% of hysterectomies
continue to be performed abdominally, whereas 22% are performed vaginally,
and 23% laparoscopically. By comparison during the past year at Women’s
Health Specialists our rates of abdominal, vaginal, and laparoscopic hysterectomy
were 23%, 20%, and 57%, respectively. Consequently, this emphasis on minimally
invasive surgery brings a little bit of the advancements Europeans enjoy
to women in the San Francisco Bay Area.
Why should women in need of a hysterectomy seek surgeons who prefer
minimally invasive procedures? A large body of medical literature has clearly established that when
compared to abdominal hysterectomy, vaginal and
laparoscopic hysterectomy obviates the need for large incisions, minimizes disruption to bowel function,
results in significantly less pain, and most importantly facilitates a
rapid return to regular activities.
Despite many gynecologists’ objections to the contrary, most women
with fibroids, previous pelvic surgery, and endometriosis remain excellent
candidates for less invasive hysterectomy procedures.