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Safer Care Victoria’s Best Care resources support patients and healthcare providers to have conversations and make decisions together about the most appropriate pathways for care.

This resource, developed for clinicians, details a specific elective surgery procedure that should now only be done for specific indications. Evidence-based recommendations that detail ‘best care’ pathways should be discussed with your patient to determine the most appropriate pathway of care.

Advice

Minimally invasive approaches to hysterectomy should be performed, whenever feasible.

Vaginal and laparoscopic procedures are considered ‘minimally invasive’ surgical approaches and are typically associated with shorter hospitalisation and recovery times. The vaginal approach is preferred among the minimally invasive approaches.

Laparoscopic hysterectomy is a preferable alternative to open abdominal hysterectomy for those patients in whom a vaginal hysterectomy is not indicated or feasible.

When is the procedure indicated?

The choice of hysterectomy route is individualised to the patient with consideration to factors such as:

  • the extent of gynaecological pathology 
  • the relative risks and benefits of the hysterectomy route 
  • the need to perform additional procedures 
  • patient preference.

Best care recommendations

Less invasive, uterine-preserving surgical procedures should be offered before hysterectomy, if indicated.

Should a hysterectomy be deemed necessary, minimally invasive approaches to hysterectomy should be performed, whenever feasible. Vaginal and laparoscopic procedures are considered ‘minimally invasive’.

Evidence

AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL Position Statement: Route of hysterectomy to treat benign uterine disease. Journal of Minimally Invasive Gynecology [Internet] 2011 Jan–Feb [cited 2020 Jun 22]; 18(1):1-3. 

Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BWJ, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database of Systematic Reviews [Internet]. 2015 Aug [cited 2020 Jun 22].

Committee on Gynecologic Practice. Committee Opinion No 701: Choosing the route of hysterectomy for benign disease. Obstetrics & Gynecology [Internet] 2017 Jun [cited 2020 Jun 22].

Page last updated: 23 Dec 2020

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