title: [Hysterectomy for benign gynaecological disease: Surgical approach, vaginal suture method and morcellation: Guidelines].
abstract: OBJECTIVE
  To provide clinical practice guidelines from the French college of obstetrics and gynaecology (CNGOF), based on the best evidence available, concerning the surgical approach, the vaginal suture method, the surgeon's experience and morcellation to avoid complications with hysterectomy for benign gynaecological disease.
  
  
  METHODS
  English and French review of literature about complications with hysterectomy for benign gynaecological disease, excluding cancer.
  
  
  CONCLUSIONS
  For benign gynaecological disease, vaginal (VH) or laparoscopic (LH) hysterectomy are recommended (grade B). In case of big uterus, VH or LH are recommended (grade C). VH is not contraindicated in nulliparous (Grade C). VH is not contraindicated in case of previous caesarean (grade C). In obese women, VH and LH are recommended (grade C). It should be recommended to perform at least 30 hysterectomies during learning curve (grade C). Hysterectomy should be performed by surgeon doing at least 10 hysterectomies each year (grade C). No vaginal suture method is recommended (grade C). It is recommended to assess cancer risk before (histological sample and/or imagery) when morcellation is planned (expert opinion).
authors.affiliation: Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France. Electronic address: tristan.gauthier@chu-limoges.fr.
authors.forename: T
authors.initials: T
authors.lastname: Gauthier
authors.affiliation: Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France.
authors.forename: S
authors.initials: S
authors.lastname: Huet
authors.affiliation: Département de gynécologie-obstétrique, hôpital La-Conception, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Marcelli
authors.affiliation: Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon-Bron, France.
authors.forename: G
authors.initials: G
authors.lastname: Lamblin
authors.affiliation: Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon-Bron, France.
authors.forename: G
authors.initials: G
authors.lastname: Chêne
mesh_terms: D005260:Female; D005602:France / Q000453:epidemiology; D005831:Genital Diseases, Female / Q000453:epidemiology / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D000069577:Morcellation / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011247:Pregnancy; D013536:Suture Techniques / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D014621:Vagina / Q000601:surgery
keywords: Benign gynaecological disease; Fermeture vaginale; Hysterectomy; Hystérectomie; Morcellation; Morcellement; Pathologie bénigne; Surgical approach; Vaginal suture; Voie d’abord