Alternative approaches to hysterectomy: clinical and economic implications for managed care

Hysterectomy is one of the most frequently performed surgical procedures in the United States. Through advances in pharmacological and surgical technologies, opportunities now exist for converting selected hysterectomies from the traditional abdominal approach to vaginal or laparoscopically-assisted vaginal procedures. Such conversions may lead to diminished operative morbidity, fewer hospital days, a decreased period of convalescence, and the opportunity for cost savings. This paper reviews current clinical thought on the subject and considers the economic effect for providers of care.