title: Surgical approach to hysterectomy: introducing the concept of technicity.
abstract: Despite national guidelines recommending that most hysterectomies should be performed vaginally or with laparoscopic assistance, the majority are still performed by laparotomy. Advocating for minimally invasive hysterectomy requires a strategy outlining the benefits and risks of the various approaches. We propose the use of "technicity," an index that has been used in France to compare the performance of hospitals across the country. Technicity is defined by the number of hysterectomies performed vaginally and laparoscopically divided by the total number of hysterectomies performed annually in a single department. We have developed a scoring system to demonstrate the advantages of less invasive surgical approaches, thereby supporting the concept of technicity and its relevance to practice. Using technicity, gynaecologists throughout Canada can monitor their shift towards minimally invasive procedures for hysterectomy, for the benefit of patients and society.
authors.affiliation: Department of Obstetrics and Gynaecology, Centre Hospitalier de l'Université Laval, Quebec City QC.
authors.forename: Philippe Y
authors.initials: PY
authors.lastname: Laberge
authors.affiliation: Society of Minimally Invasive Gynaecology, Department of Obstetrics and Gynaecology, University of Ottawa/The Ottawa Hospital, Ottawa ON.
authors.forename: Sukhbir S
authors.initials: SS
authors.lastname: Singh
mesh_terms: D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D010535:Laparoscopy; D007902:Length of Stay; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011788:Quality of Life