ABSTRACT
According to a recent cross-sectional analysis of hysterectomy rates in the United States derived from the discharge data from the 2003 nationwide inpatient sample, 33.6% of all benign hysterectomies are performed via a minimally invasive route, with 21.8% performed vaginally, and 11.8% performed laparoscopically ( 1 ). Although vaginal hysterectomy has been shown to be the preferred route for hysterectomy due to its lower morbidity and cost when compared with abdominal or laparoscopic hysterectomy, it is often not utilized by gynecologic surgeons for one of the above-mentioned reasons ( 2-4 ). Laparoscopy offers several benefits over open abdominal hysterectomy, including shorter hospitalization, lower intra-operative blood loss, and less postoperative pain ( 5 , 6 ). These advantages, however, must be weighed against laparoscopy’s steep learning curve, longer surgical times, limited tactile feedback, limited depth perception, instrument range of motion limited to an x and y axis, counterintuitive instrument movement, and poor ergonomics for the surgical team ( 6-8 ).
