117: Changing Hysterectomy Technique: New Trend in Oslo, Norway

Abstract

To evaluate the operative hysterectomy technique in women treated for symptomatic uterine fibroids. University tertiary referring center in Oslo, Norway. Investigation of the hysterectomy technique over a 4 years period in Oslo area with a population of 750 000. Patient operative record was investigated in 1279 women treated with hysterectomy. Investigation of operative patient record; if the surgery was performed with laparotomy or laparoscopy, as well as the indication for surgery. A total of 1279 hysterectomies were performed in the period 2001-2004. In 2001, 45 (13.8%) laparoscopic subtotal hysterectomies and 23 (7%) total laparoscopic hysterectomies were performed, while 258 (79.3%) of the hysterectomies were done with laparotomy. The indication for surgery was fibroids in 79% of the laparotomies, 44% in the endoscopic group. This trend has changed gradually through the years. In 2004, 58% of the surgical procedures were laparoscopic, 155 (44%) subtotal and 49 (14%) total laparoscopic hysterectomy. The indication for surgery in 2004 was fibroids in 88% in the laparotomy group, 69% in the endoscopic group. From 2001 to 2004 a trend shift of the operative technique has been seen in Oslo, increasing the endoscopic hysterectomies from 20.8% to 58%. During the same time, larger fibroid uteri are increasingly converted to laparoscopic subtotal hysterectomy, from 44% to 69%. With modern equipment and trained staff more of the routine hysterectomies can be managed endoscopically.