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Human Reproduction, Vol. 14, No. 10, 2464-2470, October 1999
© 1999 European Society of Human Reproduction and Embryology

Hysterectomy techniques used for benign pathologies: results of a French multicentre study

Charles Chapron1,4, Laurent Laforest2, Yann Ansquer1, Arnaud Fauconnier1, Bruno Fernandez1, Gérard Bréart3 and Jean-Bernard Dubuisson1

1 Service de Chirurgie Gynécologique (Pr Dubuisson), Clinique Universitaire Baudelocque, CHU Cochin Port-Royal, 123, Boulevard Port-Royal, 75014 Paris, 2 Direction Départementale des Affaires Sanitaires et Sociales (DDASS) du Loiret, 131 rue du Faubourg Bannier, F-45042 Orléans and 3 Unité INSERM 149, CHU Cochin Port-Royal, 123, Boulevard Port-Royal, 75014 Paris, France

The objective of this study was to assess the techniques by which hysterectomies are carried out and to determine the rate of total laparoscopic hysterectomy (TLH). A transversal multicentre study was conducted in 23 gynaecology and obstetrics departments of French University Hospital Centres. The study population comprised only those patients for whom hysterectomy was indicated for benign disease without genital prolapse or urinary stress incontinence. Whereas the rates of performance of hysterectomy by laparotomy and by the vaginal route are comparable [respectively 40.0% (94 patients) and 46.8% (110 patients)], the rate of performance of TLH is only 13.2% (31 patients). All 23 centres (100%) carried out hysterectomy by laparotomy and 21 centres (91.3%) carried out vaginal hysterectomy; however, only nine centres (39.1%) carried out TLH. Only seven centres (30.4%) performed all three types of operation. Of the eight centres whose rate of vaginal hysterectomy was >60%, six (75%) did not carry out TLH. The study suggests that the usage of the TLH technique appears to be limited. The extent of surgical training is a major factor in the choice of technique for hysterectomy.

Key words: laparotomy/operative laparoscopy/total hysterectomy/vaginal surgery

4 To whom correspondence should be addressed


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