Changing hysterectomy technique from open abdominal to laparoscopic: New trend in Oslo, Norway

STUDY OBJECTIVE: To evaluate the change in hysterectomy technique. DESIGN: Retrospective. study (Canadian Task Force classification XXX). SETTING: University tertiary referring center in Norway. PATIENTS: A total of 1963 women treated with hysterectomy over a 5-year period in Oslo. INTERVENTIONS: The operative records and techniques were investigated in all treated patients. MEASUREMENTS AND MAIN RESULTS: A total of 1963 hysterectomies were performed from 2001 through 2005. The operative patient records were investigated with the main focus on indication for surgery and the technique used in the operative procedure. In 2001, 62 (17.7%) laparoscopic hysterectomies were performed, while 256 (73.1%) of the hysterectomies were done with laparotomy. The operative technique has gradually changed during the last 5 years. In 2005, 220 (53.5%) of the surgical procedures were laparoscopic, 177 (43.1%) were done by laparotomy, while the vaginal approach in all these years was less than 10%. CONCLUSION: From 2001 to 2005, a trend shift of the operative technique has been observed in Oslo, increasing the endoscopic hysterectomy rate from approximately 18% to 54%. During the same time, enlarged uteri with myomas equivalent to 10 to 12 weeks' gestation and endometrial cancer were more often treated by laparoscopic hysterectomy instead of open abdominal hysterectomy. With modem equipment and trained staff, more routine hysterectomies can be managed with laparoscopy. (C) 2007 AAGL. All rights reserved.