Laparoscopic hysterectomy for benign indications: clinical practice guideline

Area of Science:

• Gynecologic Surgery
• Minimally Invasive Procedures

Background:

• Minimally invasive gynecologic surgery, particularly advanced laparoscopic procedures, has seen a significant global increase.
• Standardizing care based on evidence-based medicine is timely for laparoscopic gynecologic procedures.

Purpose of the Study:

• To develop a national guideline for laparoscopic hysterectomy (LH) in The Netherlands.
• To standardize laparoscopic gynecologic care using evidence-based principles.

Main Methods:

• Guideline development followed Dutch medical specialist guidelines and AGREE II criteria.
• Key clinical issues were identified, research questions formulated, and literature searched.
• Evidence quality was assessed using GRADE; recommendations were formulated by an expert panel of 18 gynecologists.

Main Results:

• Ten key topics were addressed, including hysterectomy approaches, tissue extraction, pre-operative treatment, and ureter injury prevention.
• A clinical practical guideline for LH was created, featuring evidence- and expert-based recommendations.
• The guideline is currently undergoing implementation across The Netherlands.

Conclusions:

• A comprehensive guideline for laparoscopic hysterectomy (LH) has been established.
• It offers best clinical practice recommendations to standardize care and guide daily practice.
• The guideline aims to ensure and improve the quality of LH nationally and internationally.