Photo Credit: Hulko

The following is a summary of “Association Among Surgeon Volume, Surgical Approach, and Uterine Size for Hysterectomy for Benign Indications,” published in the October 2024 issue of Obstetrics and Gynecology by Santiago et al.  

Hysterectomies for benign indications can be performed using various surgical approaches, and the surgeon’s experience may influence the choice of approach, especially about uterine size.    

Researchers conducted a retrospective study examining how surgeon volume relates to the surgical approach for hysterectomy in patients with different uterine sizes.    

They reviewed data from the Michigan Surgical Quality Collaborative registry (2012–2021) for patients undergoing hysterectomy for benign conditions. Surgeons were categorized into low-, intermediate-, and high-volume tertiles based on the annual hysterectomy contributions. The uterine size was represented by uterine specimen weight and categorized for clinical interpretation. Multivariable logistic regression models with interaction terms for surgeon volume and uterine size were used to assess effect modification.    

The results showed 54,150 hysterectomies, compared to low-volume surgeons, hysterectomies by intermediate- and high-volume surgeons were more likely to be performed minimally invasively (aOR 1.68, 95% CI, 1.47–1.92; aOR 2.14, 95% CI, 1.87–2.46, respectively). For uteri weighing 1,000 g to 1,999 g, intermediate-volume surgeons had an aOR of 3.38 (95% CI, 2.04–5.12), and high-volume surgeons had an aOR of 9.26 (95% CI, 5.64–15.2) for minimally invasive approaches. Surgeon volume modified the relationship between uterine size and surgical approach, especially for uteri up to 3,000 g.    

They concluded that high-volume surgeons were more likely to perform minimally invasive hysterectomies for uteri weighing up to 3,000 g compared with low-volume surgeons.  

Source: journals.lww.com/greenjournal/abstract/9900/association_among_surgeon_volume,_surgical.1163.aspx