Home E-Weekly November 16, 2010

GYN Group Urges Less Invasive Surgeries

Published: November 15, 2010

Noting the low surgical risks, reduced morbidity and faster recovery in vaginal and laparoscopic hysterectomies, the American Association of Gynecologic Laparoscopists is urging more physicians to perform or refer patients to these options.

In an evidence-based position statement published online last week in conjunction with the group's annual meeting and in advance of the January/February issue of the Journal of Minimally Invasive Gynecology, the AAGL makes the case that most hysterectomies should be done in minimally invasive fashion.

"When hysterectomy is necessary, the demonstrated safety, efficacy, and cost-effectiveness of VH and LH mandate that they be the procedures of choice," says Franklin Loffer, MD, the organization's medical director and executive vice president. "When hysterectomy is performed without a laparotomy, early institutional discharge is feasible and safe, in many cases within the first 24 hours."

Of the approximately 600,000 hysterectomies performed in the U.S. each year, more than two-thirds presently involve an abdominal incision, opening patients to surgical site infection risks, hospital stays and long recovery periods. According to the AAGL, few patients are not viable candidates for vaginal or laparoscopic approaches. For instance, while obese patients were once ruled out, the safety and efficacy of their procedures match that of non-obese patients.

The AAGL's statement follows an advisory opinion issued by the American College of Obstetricians and Gynecologists last year which dubbed vaginal hysterectomy the safest, most cost-effective approach.

David Bernard

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