Total laparoscopic hysterectomy

Alternatives to hysterectomy can provide excellent treatment outcomes for many women. In general, these alternatives are underused. For some women, however, alternative treatments fail and hysterectomy provides the best approach. The goal of future research should be to define better this group of women. For women who require hysterectomy, the laparoscopic approach affords the benefit of less postoperative discomfort, shorter hospital stay, and quicker recovery. The surgical techniques and instruments for laparoscopically directed hysterectomy are still in development. Few randomized, prospective studies that involve large numbers of patients have compared the risks and benefits of this approach with standard hysterectomy. In addition, data on the effectiveness of the operation, as performed by large numbers of gynecologists, are still not clear. Although the potential for real benefit exists, it is hoped that further study will clarify the place of laparoscopic-assisted hysterectomy in the nonsurgical and surgical treatment offered to patients.