Total Hysterectomy by Laparoscopy: Advantage for the Patient or Only a Surgical Gimmick?

ABSTRACT

The majority of hysterectomies are performed by laparotomy. With laparoscopic surgery, it will be possible to perform only 10%–20% of hysterectomies by the abdominal route. Even if laparoscopic hysterectomy is a feasible technique, not all hysterectomies should be performed by the endoscopic route. Laparoscopic surgery is never an alternative to vaginal surgery. Laparoscopic surgery is not indicated for hysterectomy if the operation is feasible quickly and under good conditions via the vaginal route. Laparoscopic surgery is only indicated when vaginal surgery is difficult or contraindicated. In these situations, laparoscopic surgery can be performed by two different modalities: laparoscopically assisted vaginal hysterectomy and total hysterectomy completely performed by laparoscopy. (J GYNECOL SURG 12:75, 1996)