To describe changes in same day discharges (SDD) following minimally invasive hysterectomy (MIH) in a national surgical database across a 9-year period and forecast anticipated utilization over the subsequent decade. A cross-sectional secondary analysis of the 2011-2019 National Surgical Quality Improvement Program (NSQIP) Database combined with an autoregressive linear forecasting model of SDD utilization from 2020-2029. MIH were identified by current procedural terminology (CPT) code and indication for surgery based on primary diagnosis ICD-CM coding. Individuals with an oncologic diagnosis or concomitant non-gynecologic procedure were excluded. Multivariable logistic regression was used to control for individual-level confounding factors. 239,242 MIH were included in the analysis. Over the 9-year period, there was a sustained increased utilization of SDD across all MIH (13.0% in 2011 to 23.7% in 2019; Cochran Armitage test for trend P<0.001). Surgery for a diagnosis of pelvic organ prolapse was associated with a 15.8% lower rate of SDD compared to those with another benign indication (P<0.001) and this gap increased across time (P<0.001) (Figure 1). Moreover, the observed differences persisted when controlling for individual confounders including age, ASA classification, BMI, functional status, presence of major medical comorbidities, and route of hysterectomy (aOR for prolapse 0.40 (95% CI 0.38, 0.42)). Route of hysterectomy also affected SDD rate, with total laparoscopic hysterectomy having the highest rate of SDD (28.3%) while total vaginal hysterectomy was associated with the lowest (12.0%) (aOR for vaginal hysterectomy 0.47 (95% CI 0.45, 0.48). Based on the demonstrated trends, forecasting models estimate overall utilization of SDD will increase to 48.5% (95% CI 38.7-58.4) by 2029 (Figure 2). While utilization is increasing, the overall rate of SDD following MIH remains low, particularly among individuals undergoing surgery for pelvic organ prolapse and by a vaginal approach. Given its well established safety profile, additional strategies to facilitate SDD of patients undergoing MIH should be adopted.View Large Image Figure ViewerDownload Hi-res image Download (PPT)