Citation: Gynecological Surgery. 2015, 12(1) SUPPL. 1(S471), 1613-2076
Author: Rowlands D.; Gul N.; Minas V.; King S.
Abstract: Background The EVALUATE study previously reported that for benign conditions and small moderatety enlarged uteri that vaginal hysterectomy was preferable to abdominal or
laparoscopic hysterectomy. And that laparoscopic hysterectomy is preferable to
abdominal. We have previously reported (RCOG World Congress 2015) that <8% of
hysterectomies performed in our unit in a sample size of 327 of 1258 hysterectomies
performed in our unit between 1/1/2010 and 31/12/14 would have been eligible for the
EVALUATE study. We postulate that this is as a consequence of less invasive treatments
such as endometrial ablation and the Mirena IUS. In the UK, despite evidence, the
majority of hysterectomies are still performed abdominally. We describe the difference
that a cultural attitude to laparoscopic surgery has had in reducing our abdominal
hysterctomy rates to under 10% . Methods Review of all hysterectomies performed at
Wirral University Teaching Hospital 1/1/2010 - 31/12/2010 and 1/1/2014 - 31/12/2014 by
type. There were no exclusions . Hysterectomies performed for ovarian cancer, cervical
cancer and high grade endometrial cancer are performed in the Regional Cancer Centre.
Results Results will show an extremely low abdominal hysterectomy rate which has
further fallen within this 5 year period as a consequence of training and education within
the unit. The unit has an inclusive approach towards safe laparoscopic surgery with an
ethos not to perform abdominal procedures wherever possible. With retirements, new
appointments, and education and traing we present results which we believe are
unparalleled in any other UK large hospital but demonstrate that with commitment
support and education we believe this is possible anywhere. Conclusions Abdominal
hysterectomy is in many cases an unnecessary major operation which can be succesfully
and safely achieved through minimal access surgery in almost all cases
