Outdated surgical choices put women at risk

May 16, 2018 by Claire Usmar, University of Queensland
Outdated surgical choices put women at risk
Credit: University of Queensland

Australian women are undergoing unnecessarily invasive hysterectomies due to a lack of contemporary surgical skills among gynaecologists.

University of Queensland research has found many gynaecologists have not updated their skills, despite evidence supporting less invasive procedures.

Queensland Centre for Gynaecological Cancer Research Director Professor Andreas Obermair said many gynaecologists recognised the advantages of laparoscopic (keyhole) , but a lack of training meant many could not perform the procedure.

"Overwhelming evidence suggests that has better patient and societal benefits than traditional open hysterectomy," he said.

"The procedure is associated with a shorter hospital stay, quicker recovery, better quality of life and less cost to the health care system.

"However, we found surgeons were choosing to perform open hysterectomies instead because they were very experienced in that—essentially they were comfortable doing what they've always done."

Open hysterectomy involves the removal of the uterus and potentially all reproductive organs via a large cut.

A laparoscopic hysterectomy is a minimally invasive keyhole surgical using three or four incisions no longer than six millimetres.

Professor Obermair said the study also found that laparoscopy workshops failed to provide adequate training.

"These workshops don't really teach them how to do this operation and, as specialists, there's no regulatory need to update their surgical skills," he said.

"A trainee learns all the time, they're used to it, but once you're a specialist there's this expectation from society that you know it all."

The study has informed a program funded by the National Health and Medical Research Council aimed at updating the of gynaecologists in Queensland.

"We are now training 10 specialists so that they're able to reduce the use of open hysterectomies and offer less invasive alternatives," Professor Obermair said.

An initial test program at one hospital in the greater Brisbane area saw doctors choose laparoscopic hysterectomies over open hysterectomies in the majority of cases, with surgical complication rates falling by one-third.

The research is published in the Australia and New Zealand Journal of Obstetrics and Gynaecology

Explore further: Approach to hysterectomy varies despite advances

More information: Monika Janda et al. Surgical approach to hysterectomy and barriers to using minimally invasive methods, Australian and New Zealand Journal of Obstetrics and Gynaecology (2018). DOI: 10.1111/ajo.12824

Related Stories

Approach to hysterectomy varies despite advances

April 1, 2013
(Medical Xpress)—By age 65, one-third of women in the United States will have a hysterectomy, an operation to remove the uterus. Most women will undergo a traditional abdominal hysterectomy, despite advances in minimally ...

Plotting the downward trend in traditional hysterectomy

January 23, 2018
Fewer women are getting hysterectomies in every state across the country.

Findings support use of less invasive hysterectomy for early-stage endometrial cancer

March 28, 2017
Researchers found similar rates of disease-free survival and no difference in overall survival among women who received a laparoscopic or abdominal total hysterectomy for stage I endometrial cancer, according to a study published ...

Increase seen in use of robotically-assisted hysterectomy for benign gynecologic disorders

February 19, 2013
Between 2007 and 2010, the use of robotically-assisted hysterectomy for benign gynecologic disorders increased substantially, although, when compared with laparoscopic hysterectomy, the robotic procedure appears to offer ...

Study looks at impact of FDA safety alert on morcellation

January 23, 2016
(HealthDay)—The use of minimally invasive hysterectomy decreased and postoperative complications increased following the U.S. Food and Drug Administration safety communication discouraging use of laparoscopic power morcellation ...

OB/GYNs told robot hysterectomy not best option

March 14, 2013
Pricey robotic surgery should not be the first or even second choice for most women who need a hysterectomy, says advice issued Thursday to doctors who help those women decide.

Recommended for you

Why mothers in mainland China, Hong Kong and Taiwan choose cesarean delivery

October 16, 2018
Pregnant women in mainland China, Hong Kong, and Taiwan are more likely to express preference for cesarean section (CS) as their mode of delivery later in pregnancy and postpartum, as compared to early in pregnancy, according ...

Importance of cell cycle and cellular senescence in the placenta discovered

October 15, 2018
Working with researchers from Stanford University and St. Anna Children's Cancer Research, researchers from Jürgen Pollheimer's laboratory at the Medical University of Vienna's Department of Obstetrics and Gynecology have ...

C-section rates have nearly doubled since 2000: study

October 12, 2018
(HealthDay)—The number of women delivering babies via cesarean section has nearly doubled worldwide since 2000, to about 21 percent, new research shows.

Study of nearly 41,000 women who almost died giving birth shows who's most at risk

October 10, 2018
Tens of thousands of American women each year need emergency treatment to save their lives while they deliver their babies, or immediately after. A new study shows how much their risk of a life-threatening birth depends on ...

In childbirth, when to begin pushing does not affect C-section rates

October 9, 2018
More than 3 million women in the United States give birth each year. But obstetricians have differing opinions about when women should begin pushing during labor and whether the timing of pushing increases the likelihood ...

Why single embryo transfer during IVF sometimes results in twins or triplets

October 8, 2018
It has been known for some time that it is better to transfer a single embryo to a woman's womb during assisted reproduction treatment (ART) rather than several embryos in order to avoid a multiple pregnancy and the risks ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.