title: Total laparoscopic hysterectomy: indications, techniques and outcomes.
abstract: OBJECTIVE
  The indications, techniques and outcomes of laparoscopic associated hysterectomy and especially total laparoscopic hysterectomy are thoroughly reviewed.
  
  
  RESULTS
  The original technique for total laparoscopic hysterectomy is detailed as it is still applicable. The total laparoscopic hysterectomy operation has not changed to any major degree over the past 15 years. The technique detailed works well and lessens the chance for a ureteral injury. Expansion of the technique has occurred in oncology. Evidence-based studies support the use of vaginal hysterectomy if possible over laparoscopic and abdominal hysterectomy. They also support a laparoscopic approach to hysterectomy over total abdominal hysterectomy.
  
  
  CONCLUSIONS
  Despite evidence-based studies, gynecologic surgical specialists have been slow to adopt both laparoscopic and vaginal hysterectomy into their practice. This trend may increase in the near future. Adoption of laparoscopic associated hysterectomy has been extremely slow.
authors.affiliation: Wilkes Barre General Hospital, Wilkes Barre, Pennsylvania, USA. hrlscp@aol.com
authors.forename: Harry
authors.initials: H
authors.lastname: Reich
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome