Skip to main content
SpringerLink
Log in

Historical perspective of vaginal hysterectomy: the resilience of art and evidence-based medicine in the age of technology

  • Review
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to describe, from a historical perspective, the relevance, resilience and outcomes of vaginal hysterectomy (VH) in gynecology in the age of technological scenario.

Methods

The authors searched records from January 2011 to January 2021 on the following databases: Medline, EMBASE, and CENTRAL (The Cochrane Library) for combinations of the terms “vaginal hysterectomy,” “outcomes” AND “history”; and before that period, if the search had historical relevance. Inclusion criteria: randomized clinical trials; hysterectomy performed for benign gynecological conditions; and VH outcomes compared with Abdominal Hysterectomy (AH), Laparoscopic Hysterectomy (LH) or Robotic Hysterectomy (RH).

Results

The VH combines sequences of reproducible techniques which have been developed over the years to safely and effectively overcome the limitations of difficult cases of vaginal extirpation from the uterus.

Conclusion

The authors support endoscopic surgical approaches in complex surgery for benign indications, urogynecology, and gynecologic oncology when appropriate. However, what makes the gynecological surgeon different from the general surgeon is the vaginal access. It is essential to continue to train residents in vaginal surgical skills and provide safe and cost-effective patient care. The art of technology is the resilience of keeping only the patient at the center of innovation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Source: G. Gosen Rare Books and Old Paper, ABAA and ILAB. First edition. Latin text. [viii; 79; v (plates)] The son of Conrad Langenbeck, Maximillian Langenbeck (1818–1877)

Fig. 2

Source: Photograph: Wellcome Library, London/Creative Commons

Fig. 3

Source: authors

Similar content being viewed by others

Data availability

The authors declare that data supporting the findings of this study are available within the article.

Abbreviations

ACOG:

American College of Obstetricians and Gynecologists

ISGE:

International Society for Gynecologic Endoscopy

VH:

Vaginal Hysterectomy.

AH:

Abdominal Hysterectomy.

LH:

Laparoscopic Hysterectomy.

RH:

Robotic Hysterectomy

References

  1. American College of Obstetricians and Gynecologists (2017) Committee opinion no. 701: choosing the route of hysterectomy for benign disease. Obstet Gynecol 129:e155-9

    Article  Google Scholar 

  2. Wright JD, Herzog TJ, Tsui J, Ananth CV, Lewin SN, Lu YS et al (2013) Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstet Gynecol 122:233–241

    Article  PubMed Central  PubMed  Google Scholar 

  3. Sutton C (1997) Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol 11(1):1–22. https://doi.org/10.1016/s0950-3552(97)80047-8 (PMID: 9155933)

    Article  CAS  PubMed  Google Scholar 

  4. Sparić R, Hudelist G, Berisava M, Gudović A, Buzadzić S (2011) Hysterectomy throughout history. Acta Chir Iugosl 58(4):9–14 (PMID: 22519184)

    Article  PubMed  Google Scholar 

  5. Figueirêdo O. (2011) Vaginal Hysterectomy: New perspectives. 3rd Ed. Original in Portuguese: Histerectomia Vaginal: Novas Perspectivas. Londrina, PR, Brazil: Netto. (ISBN-85–902924–2–8)

  6. Schmitt JJ, Baker MV, Occhino JA, McGree ME, Weaver AL, Bakkum-Gamez JN et al (2020) Prospective implementation and evaluation of a decision-tree algorithm for route of hysterectomy. Obstet Gynecol 135:761–769

    Article  PubMed  Google Scholar 

  7. Gebhart JB, Schmitt JJ, Baker MV, Occhino JA, McGree ME, Weaver AL, Bakkum-Gamez JN, Dowdy SC, Pasupathy KS (2020) Vaginal hysterectomy: historical footnote or viable route? Obstet Gynecol 136(2):426

    Article  PubMed  Google Scholar 

  8. Skinner BD, Delancey JOL (2013) Selecting the route for hysterectomy: a structured approach. Contemp OB/GYN 58:24–32

    Google Scholar 

  9. Kovac SR (2014) Route of hysterectomy: an evidence-based approach. Clin Obstet Gynecol 57:58–71

    Article  PubMed  Google Scholar 

  10. Morgan DM, Kamdar NS, Swenson CW, Kobernik EK, Sammarco AG, Nallamothu B (2018) Nationwide trends in the utilization of and payments for hysterectomy in the United States among commercially insured women. Am J Obstet Gynecol 218(425):e1–e18

    Google Scholar 

  11. Louie M, Strassle PD, Moulder JK, Dizon AM, Schiff LD, Carey ET (2018) Uterine weight and complications after abdominal, laparoscopic, and vaginal hysterectomy. Am J Obstet Gynecol 219(5):480.e1-e8. https://doi.org/10.1016/j.ajog.2018.06.015 (Epub 2018 Jun 28 PMID: 29959931)

    Article  PubMed  Google Scholar 

  12. Bretschneider CE, Frazzini Padilla P, Das D, Jelovsek JE, Unger CA (2018) The impact of surgeon volume on perioperative adverse events in women undergoing minimally invasive hysterectomy for the large uterus. Am J Obstet Gynecol 219(5):490.e1-e8. https://doi.org/10.1016/j.ajog.2018.09.003 (Epub 2018 Sep 14 PMID: 30222939)

    Article  PubMed  Google Scholar 

  13. Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW et al (2015) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 12(8):CD003677

    Google Scholar 

  14. Lee SH, Oh SR, Cho YJ, Han M, Park JW, Kim SJ, Yun JH, Choe SY, Choi JS, Bae JW (2019) Comparison of vaginal hysterectomy and laparoscopic hysterectomy: a systematic review and meta-analysis. BMC Womens Health 19(1):83. https://doi.org/10.1186/s12905-019-0784-4.PMID:31234852;PMCID:PMC6591934

    Article  PubMed Central  PubMed  Google Scholar 

  15. Sandberg EM, Twijnstra ARH, Driessen SRC, Jansen FW (2017) Total laparoscopic hysterectomy versus vaginal hysterectomy: a systematic review and meta-analysis. J Minim Invasive Gynecol 24(2):206-217.e22. https://doi.org/10.1016/j.jmig.2016.10.020 (Epub 2016 Nov 17 PMID: 27867051)

    Article  PubMed  Google Scholar 

  16. Kho RM, Abrão MS (2017) In search for the best minimally invasive hysterectomy approach for the large uterus: a review. Clin Obstet Gynecol 60(2):286–295. https://doi.org/10.1097/GRF.0000000000000285 (PMID: 28319474)

    Article  PubMed  Google Scholar 

  17. Wang H, Li P, Li X, Gao L, Lu C, Zhao J, Zhou AL (2016) Total Laparoscopic hysterectomy in patients with large uteri: comparison of uterine removal by transvaginal and uterine morcellation approaches. Biomed Res Int 2016:8784601. https://doi.org/10.1155/2016/8784601 (Epub 2016 Jun 22 PMID: 27419141; PMCID: PMC4933852)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. McCarus SD (2021) Senhance robotic platform system for gynecological surgery. JSLS 25(1):e2020. https://doi.org/10.4293/JSLS.2020.00075 (PMID: 33880002; PMCID: PMC8035830)

    Article  PubMed Central  Google Scholar 

  19. American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice, The Society of Gynecologic Surgeons (2020) Robot-Assisted Surgery for Noncancerous Gynecologic Conditions: ACOG COMMITTEE OPINION, Number 810. Obstet Gynecol. 136(3):e22–e30. https://doi.org/10.1097/AOG.0000000000004048 (PMID: 32826597)

    Article  Google Scholar 

  20. Chrysostomou A, Djokovic D, Edridge W, van Herendael BJ (2018) Evidence-based guidelines for vaginal hysterectomy of the international society for gynecologic endoscopy (ISGE). Eur J Obstet Gynecol Reprod Biol 231:262–267. https://doi.org/10.1016/j.ejogrb.2018.10.058 (Epub 2018 Nov 1 PMID: 30447552)

    Article  PubMed  Google Scholar 

  21. Radosa JC, Radosa MP, Zimmermann JSM, Braun EM, Findeklee S, Wieczorek A, Stotz L, Hamza A, Takacs FZ, Risius UM, Gerlinger C, Radosa CG, Wagenpfeil S, Solomayer EF (2021) Incidence of and risk factors for vaginal cuff dehiscence following total laparoscopic hysterectomy: a monocentric hospital analysis. Arch Gynecol Obstet 304(2):447–454. https://doi.org/10.1007/s00404-021-06064-0 (Epub 2021 May 3. PMID: 33938997; PMCID: PMC8277650)

    Article  PubMed Central  PubMed  Google Scholar 

  22. Neis F, Reisenauer C, Kraemer B, Wagner P, Brucker S (2021) Retrospective analysis of secondary resection of the cervical stump after subtotal hysterectomy: why and when? Arch Gynecol Obstet 304(6):1519–1526. https://doi.org/10.1007/s00404-021-06193-6 (Epub 2021 Aug 28 PMID: 34453213; PMCID: PMC8553675)

    Article  PubMed Central  PubMed  Google Scholar 

  23. Nietzsche FW (1878) Human All Too Human. (Menschliches, Allzumenschliches: Ein Buch für freie Geister) (In German)

Download references

Acknowledgements

The authors thank the doctors´ board of the Urogynecology and Vaginal Surgery Sector of the Department of Gynecology from Federal University of São Paulo for the inspiration of the values of medicine.

Funding

The authors declare that they do not have a financial relationship with any commercial entity that has an interest in the subject of this manuscript.

Author information

Authors and Affiliations

  1. Urogynecology and Vaginal Surgery Sector, Department of Gynecology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil

    Gisele Vissoci Marquini, Leticia Maria de Oliveira, Sérgio Brasileiro Martins, Claudia Cristina Takano, Zsuzsanna Ilona Katalin de Jarmy Di-Bella & Marair Gracio Ferreira Sartori

Authors
  1. Gisele Vissoci Marquini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leticia Maria de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sérgio Brasileiro Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudia Cristina Takano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zsuzsanna Ilona Katalin de Jarmy Di-Bella
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marair Gracio Ferreira Sartori
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

GVM: Project development, data collection, writing of the manuscript. LMO: Project development, proofreading/editing of the manuscript. SBM: Proofreading/editing of the manuscript. CCT: Proofreading/editing of the manuscript. ZIKJ-DB: Project development, proofreading/editing of the manuscript. MGFS: Project development, proofreading/editing of the manuscript.

Corresponding author

Correspondence to Gisele Vissoci Marquini.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marquini, G.V., de Oliveira, L.M., Martins, S.B. et al. Historical perspective of vaginal hysterectomy: the resilience of art and evidence-based medicine in the age of technology. Arch Gynecol Obstet 307, 1377–1384 (2023). https://doi.org/10.1007/s00404-022-06607-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-022-06607-z

Keywords

Search

Navigation