Minimally invasive hysterectomy at a university teaching hospital.
OBJECTIVE
To evaluate the feasibility of a minimally invasive approach for hysterectomy for benign disease at a university teaching hospital.


METHODS
Five hundred thirty-seven consecutive patients underwent hysterectomy for benign disease at Penn State Milton S. Hershey Medical Center in 2010. No cases were excluded. Minimally invasive approaches included total vaginal hysterectomy, laparoscopy-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and laparoscopic supracervical hysterectomy. All surgeries were completed with the resident as the primary surgeon or first assistant.


RESULTS
The median age was 45 years, the median body mass index was 30 kg/m2, the median estimated uterine size was 11 cm, and 22% of patients had a prior cesarean section. Of the 537 hysterectomies, 526 (98%) were started with a minimally invasive approach and 517 (96%) were completed in that fashion; thus only 9 conversions (2%) were required. Of the cases in which a minimally invasive approach was used, 16% were vaginal and 84% were laparoscopic. The median operative time was 86 minutes, the median blood loss was 95 mL, the median hospital stay was 1 day, and the median uterine weight was 199 g. For the minimally invasive hysterectomies, there was a 5% major complication rate.


CONCLUSIONS
Our residency training institution completed 96% of 537 hysterectomies using a minimally invasive approach while maintaining an acceptable operative time, amount of blood loss, hospital stay, and complication rate. Thus our study supports that a minimally invasive approach for hysterectomy for benign disease at an academic resident teaching facility is feasible.
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Michael
M
Mitri
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
James
J
Fanning
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Matthew
M
Davies
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Joshua
J
Kesterson
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Serdar
S
Ural
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Allen
A
Kunselman
Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Gerald
G
Harkins
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006784:Hospitals, Teaching; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011247:Pregnancy; D055815:Young Adult
Minimally invasive hysterectomy; Resident program