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ACOG questions benefit of robotic hysterectomy

The President of the American Congress of Obstetricians Gynecologists James T. Breeden, MD released a statement this month recommending the advantages of vaginal and laparoscopic hysterectomies (including Single Incision Laparoscopic Surgery or SILS hysterectomy) over daVinci robotic hysterectomies.http://acog.org/About_ACOG/News_Room/News_Releases/2013/Statement_on_Robotic_Surgery

In May of last year, a randomized trial between vaginal and (multi-incision) laparoscopic hysterectomies found laparoscopic hysterectomies were associated with less pain, quicker return to work than vaginal hysterectomies. Vaginal hysterectomies were associated with less cost to the system but more pain.

My spin is one should avoid an open incision (abdominal hysterectomy). They may be necessary but should be rare. Go with laparoscopic hysterectomy for less pain and quicker recovery; go with SILS hysterectomy for even less incisions than traditional laparoscopic hysterectomies. Whatever you do make sure you get a second opinion or at least feel very comfortable with your doctor's experience and plan of care.

RCM

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