Vaginal hysterectomy: Hysterectomy

Hysterectomy is the most common non-pregnancy-related surgical procedure performed in the USA. The ratio of abdominal operations to vaginal operations is 3:1, which probably reflects surgeon's experience and practice styles, the absence of clear guidelines for selecting a surgical route, lack o...

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Bibliographic Details
Published in:Baillière's clinical obstetrics and gynaecology 1997-03, Vol.11 (1), p.95-110
Main Author: KOVAC, S. R
Format: Article
Language:English
Subjects:
Appendectomy
Biological and medical sciences
Contraindications
Female
Humans
Hysterectomy, Vaginal - methods
Medical sciences
Ovariectomy
Practice Guidelines as Topic
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Ureter - anatomy & histology
Ureter - injuries
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Summary:Hysterectomy is the most common non-pregnancy-related surgical procedure performed in the USA. The ratio of abdominal operations to vaginal operations is 3:1, which probably reflects surgeon's experience and practice styles, the absence of clear guidelines for selecting a surgical route, lack of patient knowledge about the options, and inappropriate decision-making. With the trend toward evidence-based and outcome-based practice, the indications and contraindications for abdominal, vaginal, and laparoscopically-assisted hysterectomy must be examined critically. In the author's extensive experience the rates of abdominal, vaginal, and laparoscopically-assisted procedures are 1.9, 88.7, and 9.4%, respectively. Techniques useful in vaginal hysterectomy with or without simultaneous oophorectomy, the pros and cons of simultaneous incidental appendectomy, and methods of protecting the ureter are discussed.
ISSN:0950-3552
1879-2790
DOI:10.1016/S0950-3552(97)80052-1