Comment on the New DGGG AWMF S3-Guideline on Hysterectomy, or a Plea for LAVH as the Gold Standard for Total Hysterectomy Procedures

DOI http://dx.doi.org/ 10.1055/s-0035-1568167 Geburtsh Frauenheilk 2016; 76: 365–366 © Georg Thieme Verlag KG Stuttgart · New York · ISSN 0016‑5751 Correspondence Rudy Leon De Wilde, Director of the Klinik für Frauenheilkunde, Geburtshilfe und Gynäkologische Onkologie Universitätsklinik für Gynäkologie Pius-Hospital Oldenburg Carl von Ossietzky Universität Oldenburg Georgstraße 12 26121 Oldenburg rudy-leon.dewilde@ pius-hospital.de 365 De Wilde RL. Comment on the … Geburtsh Frauenheilk 2016; 76: 365 –366 Comment Deutsche Version unter: www.thieme-connect.de/ ejournals/gebfra al point of view, the expertise required to perform vaginal hyster- ectomy – and after all, LAVH is only a variant of this form of sur- gery – is only available from gynecological surgeons, which addi- tionally protects our field from other medical specialties. In summary, based on the newly compiled guideline on hysterec- tomy which, in turn, was based on a review of the existing na- tional and international literature, because of its safety and effi- cacy as well as the reduced numbers of complications LAVH must be considered the gold standard for total hysterectomy . Conflict of Interest ! There is no conflict of interest.

1 Neis K, Kreienberg R, Beckmann MW et al. S3-Leitlinie zur Indikation und Methodik der Hysterektomie. AWMF online. Online: www.awmf. org/uploads/tx_szleitlinien/015-070e_S3_Indikation_und_Methodik_ der_Hysterektomie_2015-07.pdf; last access: 21.12.2015 2 Raatz D. Preoperative laparoscopy for determination of the surgical ap- proach. Geburtsh Frauenheilk 1985; 45: 898 –900 3 Reich H. Laparoscopic hysterectomy. Surg Laparosc Endosc 1992; 2: 85–88 4 Müller A, Thiel FC, Renner SP et al. Hysterectomy – a comparison of ap- proaches. Dtsch Arztebl Int 2010; 107: 353 –359 5 Cipullo L, Cassese S, Fasolino L et al. Laparoscopic hysterectomy and urological lesions: risk analysis based on current literature and pre- ventive strategies. Minerva Ginecol 2008; 60: 331 –337 6 De Wilde RL, Trew G. Postoperative abdominal adhesions and their pre- vention in gynaecological surgery. Gynecol Surg 2007; 4: 161 –168 7 De Wilde RL, Trew G. Postoperative abdominal adhesions and their pre- vention in gynaecological surgery. Part 2. Gynecol Surg 2007; 4: 243 – 253 8 Yi YX, Zhang W, Zhou Q et al. Laparoscopic-assisted vaginal hysterec- tomy vs. abdominal hysterectomy for benign disease: a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2011; 159: 1–18 9 Schmidt EH, De Wilde RL. Standardverfahren der minimal-invasiven Chirurgie in der Frauenheilkunde. Stuttgart: Thieme; 1998: 137 –145 10 Brandner P, Neis KJ. The significance of laparoscopically-assisted vagi- nal hysterectomy – LAVH. Zentralbl Gynakol 1995; 117: 620 –624 11 Bojahr B, De Wilde RL, Tchartchian G. Malignancy rate of 10,731 uteri morcellated during laparoscopic supracervical hysterectomy (LASH). Arch Gynecol Obstet 2015; DOI: 10.1007/s00404-015-3696-z 12 Tanos V, Brölmann H, De Wilde RL et al. Myoma morcellation and sarco- ma panic. Gyn Surg 2015; 12: 17 –19 13 Brölmann H, Tanos V, Grimbizis G et al. Options on fibroid morcellation. Gyn Surg 2015; 12: 3 –15 14 Nezhat C. Morcellation during uterine tissue extraction. Online: www. aagl.org/wpcontent/uploads/2014/05/Tissue_Extraction_TFR.pdf; last access: 21.12.2015 15 Tchartchian G, Dietzel J, Bojahr B et al. No more abdominal hysterec- tomy for myomata using a new minimally-invasive technique. Int J Surg Case Rep 2010; 1: 7 –8 16 Mohan HM, O ʼRiordan JM, Winter DC. Natural-orifice translumenal en- doscopic surgery (NOTES): minimally invasive evolution or revolu- tion? Surg Laparosc Endosc Percutan Tech 2013; 23: 244 –250 17 De Wilde RL, Herrmann A. Robotic surgery – advance or gimmick? Best Pract Res Clin Obstet Gynaecol 2013; 27: 457 –469 366 De Wilde RL. Comment on the … Geburtsh Frauenheilk 2016; 76: 365 –366 GebFra Science