LAUSR

Study Objective To describe trends in utilization of laparoscopic (TLH) and vaginal hysterectomy (TVH) for benign indications in a modern cohort of women and to evaluate whether TVH remains associated with lower operative times and postoperative complications as compared to TLH or laparoscopic assisted vaginal hysterectomy (LAVH), as prior research suggests. Design A secondary analysis of the National Surgical Quality Improvement Program (NSQIP) database. Route of surgery was identified by current procedural terminology code. Primary outcomes included operative time and rates of major and minor complications. Secondary outcomes included changes in route of surgery over time. Setting N/A Patients or Participants Between 2008 and 2018, 161,626 women underwent a minimally invasive hysterectomy for benign indications without concomitant procedures. Interventions N/A Measurements and Main Results Descriptive, bivariate and multivariable mixed regression analyses were used to assess differences in outcomes, controlling for sociodemographic factors and medical comorbidities. Sensitivity analyses used a propensity-score matched cohort to balance groups across time. Rates of TVH fell from 51 to 13 percent between 2008 and 2018, while TLH increased from 12 to 68 percent (p Conclusion This analysis highlights recent shits in rates of minimally invasive hysterectomy and brings to light a resultant shift in the complication rates associated with each surgical approach, as laparoscopic hysterectomy has lower rates of complications than vaginal hysterectomy despite longer operative times.