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

The objective of this study was to assess the techniques by which hysterect omies are carried out and to determine the rate of total laparoscopic hyste rectomy (TLH), A transversal multicentre study was conducted in 23 gynaecol ogy and obstetrics departments of French University Hospital Centres, The s tudy population comprised only those patients for whom hysterectomy was ind icated for benign disease without genital prolapse or urinary stress incont inence. Whereas the rates of performance of hysterectomy by laparotomy and by the vaginal route are comparable [respectively 40.0% (94 patients) and 4 6.8% (110 patients)], the rate of performance of TLH is only 13.2% (31 pati ents). All 23 centres (100%) carried out hysterectomy by laparotomy and 21 centres (91.3%) carried out vaginal hysterectomy; however, only nine centre s (39.1%) carried out TLH. Only seven centres (30.4%) performed all three t ypes 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 usag e of the TLH technique appears to be limited. The extent of surgical traini ng is a major factor in the choice of technique for hysterectomy.