BMJ  2004;328:642-643 (13 March), doi:10.1136/bmj.328.7440.642-c

Letter

Results of eVALuate study of hysterectomy techniques

Laparoscopic hysterectomy may yet have a bright future

The first 150 words of the full text of this article appear below.

EDITOR—Garry et al showed that laparoscopic hysterectomy was associated with a higher rate of major complications than was abdominal hysterectomy.1 Can two techniques be compared, however, when one has been used for 100 years and the other for only a few months?

We found that in a group of surgeons performing laparoscopic surgery for more than 10 years the learning curve for laparoscopic hysterectomy is much greater than 25 cases, particularly when studying infrequent major complications.2 3

Comparing patients operated on between 1989 and 1995 with those operated on between 1996 and 1999, we found that the incidence of conversion to laparotomy decreased from 4.7% (33 cases out of 695) to 1.4% (13 cases out of 952), the incidence of major complications from 5.6% to 1.3%, and the operating time from 115 minutes to 90 minutes. The percentage of laparoscopic hysterectomy among non-vaginal hysterectomies, however, increased from 68% to . . . [Full text of this article]

M J Canis, professor of obstetrics and gynaecology

mcanis@chuclermontferrand.fr

A Wattiez, professor of obstetrics and gynaecology

G Mage, professor of obstetrics and gynaecology

M A Bruhat, professor of obstetrics and gynaecology

Polyclinique CHU, Boulevard Léon Malfreyt, 63000 Clermont Ferrand, France


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Relevant Article

The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy
Ray Garry, Jayne Fountain, Su Mason, Jeremy Hawe, Vicky Napp, Jason Abbott, Richard Clayton, Graham Phillips, Mark Whittaker, Richard Lilford, Stephen Bridgman, and Julia Brown
BMJ 2004 328: 129. [Abstract] [Full Text] [PDF]

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