Surgical Approach

Dr. Huffaker prefers the vaginal route for hysterectomy and reconstructive surgery over robot-assisted laparoscopic surgery and uses it whenever feasible.

Hysterectomy (uterus removal) for benign conditions is a very common surgical procedure.

Although other surgeons may claim that robot-assisted laparoscopic surgery is the best approach for hysterectomy, the American College of Obstetricians and Gynecologists (ACOG) has a different conclusion.

A recent ACOG Committee Opinion stated:

  • Vaginal hysterectomy is the approach of choice whenever feasible. Evidence demonstrates that it is associated with better outcomes when compared with other approaches to hysterectomy.

  • The vaginal approach is preferred among the minimally invasive approaches, which include laparoscopy and robot-assisted laparoscopy.

ACOG also noted that β€œThe proportion of hysterectomies performed through the robot-assisted laparoscopic approach is increasing. However, the role of robotic assistance for execution of laparoscopic hysterectomy has not been clearly determined and more data are necessary to determine the most appropriate evidence-based applications for this technology.”

Dr. Huffaker uses the vaginal approach in hysterectomies whenever appropriate because:

  • Operating time is shorter vs. laparoscopy

  • It results in higher patient satisfaction vs. laparoscopy

  • It is preferred by ACOG

  • Natural orifice, less invasive

  • No mesh