Hysterectomy is the most commonly performed major gynaecological procedure in Australia (around 29,000 pa). While evidence supports the use of less-invasive surgical approaches to hysterectomy where possible, around 1 in 4 women still receive an open-abdominal hysterectomy.

Compared with open surgery, less-invasive approaches, such as vaginal and laparoscopic (keyhole) hysterectomy are associated with a quicker faster post-operative recovery, fewer adverse events, and a reduced postoperative length of stay in hospital.

The LIgHT study examines how we can reduce the rate of open abdominal hysterectomy in Australia; it comprises two substudies:

  1. A survey, of all Australian obstetric & gynaecological specialists to explore surgical decision making relating to hysterectomy
  2. A survey to explore factors influencing decision making, and experiences of 6000 Queensland women who had received a hysterectomy in the previous two years

To date, two papers have arisen from this work:

Janda M, Armfield NR, Kerr G, Kurz S, Jackson G, Currie J, Page K, Weaver E, Yazdani A, Obermair A. Surgical approach to hysterectomy and barriers to using minimally invasive methods. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2018 May 15. https://doi.org/10.1111/ajo.12824

Key findings:

  • While the majority of surgeons wished to practice laparoscopic hysterectomy in the future, lack of surgical skills, arising from the lack of training opportunities, is the main impediment.
  • These findings echo those found in a survey conducted ten years earlier by Englund and Robson, showing that the situation has remained relatively unchanged.
  • A process of systematic education and training could provide gynaecological surgeons with the skills needed to conduct laparoscopic hysterectomy.

Janda M, Armfield NR, Page K, Kerr G, Kurz S, Jackson G, Currie J, Weaver E, Yazdani A, Obermair A. Factors influencing women’s decision making in hysterectomy. Patient education and counseling. 2017 Sep 12. https://doi.org/10.1016/j.pec.2017.09.006

Key findings:

  • Most women felt well-informed about their hysterectomy.
  • Women were more aware of the open abdominal approach than other approaches.
  • Decisions were influenced by surgeon’s preference, recovery time, and surgical risks.

Further papers are in preparation.