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Laparoscopic Assistance Overestimates Resident Exposure to Vaginal Hysterectomy
Reece Burns1, Angeline Veronikis, Hayrettin Okut
1Department of Obstetrics and Gynecology, University of Kansas Medical Center-Wichita, Wichita, KS.
Importance:
Total vaginal hysterectomy (TVH) has long been the recommended route for benign hysterectomy, though its use has been on the decline. One possibility for the decline is a decrease in resident experience during training. Since 2013, laparoscopically assisted vaginal hysterectomy (LAVH) cases have been included within the TVH minimum category reported by residency programs despite being a much different procedure.
Objectives:
Our study sought to describe resident TVH experience nationally and describe a single program's experience with TVH without laparoscopic assistance.
Study Design:
This was a retrospective study, which utilized publicly available case log data from the Accreditation Council for Graduate Medical Education to evaluate national hysterectomy case trends by graduating residency class from 2013 through 2025. Residency program case log data from a single institution were utilized to discern local trends, and the proportion of TVHs that were completed without laparoscopic assistance.
Results:
Our results demonstrate a national decline in TVH use but stable program TVH cases. Despite stability, our results identified that only 44% of TVHs are performed without laparoscopic assistance.
Conclusions:
At our institution, TVH without laparoscopic assistance represented a minority of TVH cases. Further study is needed to determine what effect this has on resident preparedness and comfort with posttraining TVH and the effect on the route of hysterectomy selection.
