Minimally Invasive Hysterectomy: Ten Years Later, Why Are We Still Falling Short?

Constructing predictive models for vaginal surgery in patients with noninvasive gynecological conditions

“…Proponents have expanded the indications for vaginal surgery and the once generally accepted contraindications to the vaginal approach no longer seem to be obstacles, such as nulliparity or no previous vaginal delivery, or a previous cesarean delivery . The unbalanced ratio of the abdominal/vaginal hysterectomy routes has not changed in the last 10 years with the predominant percentage still being the abdominal approach for up to 70% of women . Factors responsible for this choice include surgeons' expertise, patients' preferences , insufficient training and the use of limited or obsolete guidelines .…”