The declining place of abdominal hysterectomy in Australia

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Abstract
Between 1990 and 1995 in Australia, the use of abdominal hysterectomy decreased from 78 to 57% of all hysterectomies. This was due to an increase in the use of vaginal hysterectomy from 22 to 35% and the introduction of laparoscopic hysterectomy, which accounted for 8% of cases in 1994–95. Surgeons skilled in hysterectomy techniques perform abdominal hysterectomy in less than 10% of cases, because of their high rates of use of vaginal or laparoscopic hysterectomy or of both. At 4–8%, general utilization of laparoscopic hysterectomy is low in the UK, USA and Australia, and limitations in learning laparoscopic hysterectomy technique are evident. Strategies to simplify the technique have developed but their general application has yet to be demonstrated.

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