Minimally Invasive Hysterectomy Rates in Québec: Trends Over the Last Decade and Predictors of Technicity

Area of Science:

• Gynecologic Surgery
• Health Services Research
• Surgical Trends

Background:

• Hysterectomy is a common gynecologic procedure.
• The adoption of advanced surgical techniques, or 'technicity,' varies across healthcare settings.
• Understanding trends in surgical approach is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To evaluate the trends and predictors of a high technicity index for hysterectomies in Quebec.
• To analyze the shift in surgical approaches over a decade.

Main Methods:

• Retrospective study using the ADAM database (2007-2017) for 96,431 hysterectomies.
• Calculation of hospital technicity index and analysis of surgical approach trends.
• Logistic regression to identify predictors of high technicity (>70%).

Main Results:

• The overall technicity index increased from 43% to 66% over 10 years.
• Laparoscopic hysterectomies surged by 198%, while abdominal hysterectomies decreased by 50%.
• Academic centers were significantly more likely to have a high technicity index (OR 7.5).

Conclusions:

• Hysterectomy technicity is increasing in Quebec, predominantly via minimally invasive techniques.
• The shift is driven by increased laparoscopic and decreased abdominal approaches.
• Academic centers are key drivers of high-volume advanced hysterectomy procedures.