Most Hysterectomies Should be Performed Vaginally or Laparoscopically

Recommendation of the AAGL Advancing Minimally Invasive Gynecology Worldwide

Philadelphia, PA, November 7, 2010 – Approximately 600,000 hysterectomies are performed in the United States annually to treat benign disorders of the pelvis. More than two-thirds are performed through an abdominal incision. In an evidence-based position statement published online today in The Journal of Minimally Invasive Gynecology, the AAGL, a medical specialty society of over 5,000 gynecologic surgeons, advocates the practice of performing these procedures vaginally or laparoscopically in a minimally invasive manner, thus reducing morbidity and facilitating a faster recovery period.

Vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) are associated with low surgical risks and can be performed with a short hospital stay or in many instances as an outpatient procedure. Abdominal hysterectomy (AH) requires a relatively large abdominal incision and is associated with a number of disadvantages largely related to abdominal wound infections, relatively prolonged institutional stay, and delayed return to normal activities.

“When procedures are required to treat gynecologic disorders, the AAGL is committed to the principles of informed patient choice and provision of minimally invasive options,” commented Franklin D. Loffer, MD, Executive Vice President/Medical Director of the AAGL. “When hysterectomy is necessary, the demonstrated safety, efficacy, and cost-effectiveness of VH and LH mandate that they be the procedures of choice. When hysterectomy is performed without a laparotomy, early institutional discharge is feasible and safe, in many cases within the first 24 hours.”

Clinical situations once considered as contraindications to LH are obesity and a previous cesarean section. However, evidence suggests that, aside from longer operative times, safety and efficacy are similar for obese and non-obese patients. 

In conclusion the position statement asserts that “It is the position of the AAGL that most hysterectomies for benign disease should be performed either vaginally or laparoscopically and that continued efforts should be taken to facilitate these approaches. Surgeons without the requisite training and skills required for the safe performance of VH or LH should enlist the aid of colleagues who do or should refer patients requiring hysterectomy to such individuals for their surgical care.”

The article is “Route of Hysterectomy to Treat Benign Uterine Disease,” a position statement by the AAGL. Currently published as an Article in Press, it will appear in the Journal of Minimally Invasive Gynecology, Volume 18, Issue 1 (January/February 2011) published by Elsevier. doi:10.1016/j.jmig.2010.10.001

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Notes for Editors
Full text of the position statement is available to journalists upon request. Contact Francesca Costanzo at 215-239-3249 or jmigmedia@elsevier.com to obtain a copy. Journalists wishing to speak with an AAGL representative should contact Barbara Hodgson, Director of Marketing and Strategic Initiatives, AAGL Advancing Minimally Invasive Gynecology Worldwide, 714-503-6200,bhodgson@aagl.org.

About The Journal of Minimally Invasive Gynecology
The Journal of Minimally Invasive Gynecology (www.jmig.org), the official journal of the AAGL, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this dynamic field.

About The AAGL Advancing Minimally Invasive Gynecology Worldwide
The AAGL (www.aagl.org) was founded in 1971. Its vision is to serve women by advancing the safest and most efficacious diagnostic and therapeutic techniques that provide less invasive treatments for gynecologic conditions through integration of clinical practice, research, innovation, and dialogue.

About Elsevier

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Media Contact
Francesca Costanzo
Elsevier
+1 215-239-3249
jmigmedia@elsevier.com