Changing patterns of hysterectomy for benign indications - a 10-year retrospective study in a reference gynecologic...

Hysterectomy is the most commonly performed gynecological surgery and one of the most frequent operations worldwide. Although approximately 90% of hysterectomies are performed for non-oncological indications, several surgical approaches are available, including abdominal, laparoscopic, vaginal, robotic- assisted, and vNOTES techniques. With the rapid evolution of minimally invasive procedures, it is crucial to extend their application to hysterectomy, offering patients faster recovery and earlier return to daily activities. The aim of this study was to evaluate temporal trends in surgical approaches to hysterectomy in a reference gynecologic center in Poland, with a particular focus on the adoption of minimally invasive techniques.

We retrospectively analyzed hysterectomies performed for non-oncological indications between 2014 and 2024. Different surgical approaches to uterine removal were compared, and temporal trends in the proportion of minimally invasive procedures were assessed.

Over the 10-year study period, 2,421 hysterectomies were performed. The proportion of minimally invasive procedures increased markedly from 23.5% in 2014 to 70.8% in 2024. The Cochran-Armitage trend test confirmed a statistically significant upward trend in the adoption of minimally invasive techniques (Z = 12.22, p < 0.001). Log-linear modeling showed an annual percent change of 9.0% (95% CI 4.9-13.3%) toward increased use of minimally invasive surgical procedures.

The past decade has witnessed a paradigm shift in the surgical management of hysterectomy in our center, with minimally invasive techniques becoming the standard of care. This transition has provided significant benefits, underscoring the importance of further promoting minimally invasive surgery in gynecology.