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Two trials comparing types of hysterectomy may help women deciding on the operation. The options are having the uterus removed through the vagina, through an incision in the abdomen, or via keyhole, or laparoscopic surgery. Two trials comparing types of hysterectomy may help women deciding on the operation. The options are having the uterus removed through the vagina, through an incision in the abdomen, or via keyhole, or laparoscopic surgery. 1400 women were followed and while laparoscopic hysterectomies produced less pain and a faster recovery compared to abdominal operations, they took longer in theatre and were potentially not cost effective. Vaginal hysterectomies were at least as good as laparoscopy and took less time to perform. The rate of serious complications like bleeding and damage to the ureters - the tubes draining the kidneys - was low. But it was higher in laparoscopic surgery compared to abdominal operations. Overall, vaginal hysterectomy seemed to be best - faster to do than the keyhole operation, with very similar levels of pain and speed of recovery. But it is hard to generalise. These studies commenced when fewer gynaecologists were experienced in doing laparoscopic hysterectomies. It also depends on why you're having the surgery. More difficult operations may be best performed via the keyhole method and, finally, you want the surgeon to do the operation with which he or she is most experienced. But at least this evidence can help decision-making, either in regards to the surgeon or the operation.
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