RESUMEN
OBJECTIVE: The aim was to evaluate surgical routes for benign hysterectomy in a Swedish population, including abdominal and minimally invasive surgery. STUDY DESIGN: Prospectively collected data from the Swedish National GynOp Registry 2009-2015: 13 806 hysterectomy cases were included: abdominal (AH, nâ¯=â¯7485), vaginal (VH, nâ¯=â¯3767), conventional laparoscopic (LH, nâ¯=â¯1539) and robotically-assisted (RAH, nâ¯=â¯1015). RESULTS: The VH group had the shortest operation time at 75â¯min, AH 97â¯min and RAH 104â¯min. LH was longest at 127â¯min (pâ¯<â¯0.005). The mean estimated blood loss was higher in the AH group (250â¯ml) compared to all minimally invasive surgery (MIS, 65-172â¯ml); pâ¯<â¯0.005). Conversion rates were 10% for LH, 4.8% for VH and 1.6% for RAH (pâ¯<â¯0.005). Hospitalization and patient-reported time to normal activities of daily living (ADL) were longer for AH compared to MIS (pâ¯<â¯0.005). Time to return to work was eight days longer in the AH group (35â¯days) compared with the MIS groups (pâ¯<â¯0.005). Complications were fewest in the VH group at 5.4% compared with AH 7.6% and RAH 8.7% (both pâ¯<â¯0.001), but did not significantly differ from the LH group at 6.6%. Overall patient satisfaction was reported to be 86-94% one year after surgery. CONCLUSION: Women operated on for benign hysterectomy with minimally invasive methods in Sweden 2009-2015 had reduced length of hospitalization, as well as time to resuming normal ADL and return to work, compared to AH. Postoperative outcome measures were improved by minimally invasive methods and MIS should preferably be used.