[How many abdominal hysterectomies can be avoided by laparoscopic surgery?]

Laparoscopic hysterectomy performed for benign uterine lesions without prolapse is becoming more and more popular. This surgical route has some of the advantages of the vaginal route and could avoid numerous abdominal hysterectomies. Our experience shows that most of abdominal or laparoscopic hysterectomies could be done using the vaginal route which is for us the reference. One question about laparoscopic hysterectomy is: can we perform this technique to avoid abdominal hysterectomy when the vaginal route looks impossible? To answer this question, we retrospectively studied 171 hysterectomies. The laparoscopic hysterectomy rate should not reasonably exceed 10 to 15%, yet is much higher for the promotors of this technique of which advantages compared with vaginal hysterectomy are not clearly demonstrated.