ABSTRACT
Approximately 600,000 hysterectomies are performed in the United States each year, making it the second most common major operation that women undergo. Nearly one-third of all women in the United States will have a hysterectomy by the time they turn 60 years of age, with the most common indication being symptomatic fibroids. Historically performed through an abdominal approach, improvements in technology and training have led to a steady increase in the number of hysterectomies performed laparoscopically. Advantages of laparoscopic hysterectomy over the traditional abdominal approach are numerous and include improved intraoperative visualization of anatomy, shorter postoperative hospital stays, decreased postoperative pain, and improved cosmesis with smaller incisions. Drawbacks include the steep learning curve in mastering laparoscopic suturing and advanced dissections, as well as the associated costs of disposable instruments. The decision to perform a hysterectomy through a laparoscopic approach is made when enlarged, distorted anatomy precludes the vaginal approach or preoperative concern for pathology necessitates a thorough examination of the pelvis.
