ArticleObstetrics and gynecology2018
Outcomes of Hysterectomy Performed by Very Low-Volume Surgeons.
Article in Obstetrics and gynecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Minimally invasive hysterectomy same-day discharge: systematic review and meta-analysis of predictors.Archives of gynecology and obstetrics · 2024Pooled it
- Health Care Disparities in Patients Undergoing Hysterectomy for Benign Indications: A Systematic Review.Obstetrics and gynecology · 2023Pooled it
- Robotic hysterectomy and hospital performance: nationwide evidence on outcomes, efficiency, and costs in France (2020 to 2024).Journal of robotic surgery · 2026Article
- Identifying potentially modifiable risk factors associated with racially disparate postoperative outcomes following benign hysterectomy.American journal of obstetrics and gynecology · 2026Article
- Evaluation of robotic exposure among gynecological surgeons: results of survey from the young European advocates of robotic surgery (YEARS).Journal of robotic surgery · 2026Article
- Analysis of ambulatory gynecological laparoscopy in Southwestern China and predictors of discharge: a retrospective cohort : Ambulatory surgery delayed discharge analysis.Surgical endoscopy · 2025Article
- Association of body mass index with surgical complications after minimally invasive hysterectomy.Archives of gynecology and obstetrics · 2025Article
- Effects of Minimally Invasive Gynecologic Surgery Subspecialty Training on Outcomes of Hysterectomy for Benign Indications.O&G open · 2024Article
- Article
- Evaluation of the effect of previous endometriosis surgery on clinical and surgical outcomes of subsequent endometriosis surgery.Archives of gynecology and obstetrics · 2023Article
- Differences in Surgical Complications for Stage 1 Phalloplasty With Concurrent Versus Asynchronous Hysterectomy in Transmasculine Patients.The Permanente journal · 2022Article
- Predicting major complications in patients undergoing laparoscopic and open hysterectomy for benign indications.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Article
- Minimally invasive hysterectomy for benign indications-surgical volume matters: a retrospective cohort study comparing complications of robotic-assisted and conventional laparoscopic hysterectomies.Journal of robotic surgery · 2022Article
- Placenta accreta spectrum - variations in clinical practice and maternal morbidity between the UK and France: a population-based comparative study.BJOG : an international journal of obstetrics and gynaecology · 2022Article
- A review of gynaecological surgical practices for trainees and certified specialists in Australia by volume using MBS and AIHW databases.The Australian & New Zealand journal of obstetrics & gynaecology · 2022Review
- Racial disparities in complications and costs after surgery for pelvic organ prolapse.International urogynecology journal · 2022Article
- Ureteric injuries during hysterectomy-A Norwegian retrospective study of occurrence and claims for compensation over an 11-year period.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Validation of Transvaginal Hysterectomy Surgical Model - Modification of the Flowerpot Model to Improve Vesicovaginal Plane Simulation.Journal of minimally invasive gynecology · 2021Article
- Racial/Ethnic Differences in the Risk of Surgical Complications and Posthysterectomy Hospitalization among Women Undergoing Hysterectomy for Benign Conditions.Journal of minimally invasive gynecology · 2021Article
- Changes in route of hysterectomy in Norway since introduction of robotic approach.Facts, views & vision in ObGyn · 2021Article
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Funding
Abstract
objectiveTo perform a population-based analysis to first examine the changes in surgeon and hospital procedural volume for hysterectomy over time and then to explore the association between very low surgeon procedural volume and outcomes.
methodsAll women who underwent hysterectomy in New York State from 2000 to 2014 were examined. Surgeons were classified based on the average annual procedural volume as very low-volume surgeons if they performed one procedure per year. We used multivariable models to examine the association between very low-volume surgeon status and morbidity, mortality, transfusion, length of stay, and cost.
resultsAmong 434,125 women who underwent hysterectomy, very low-volume surgeons accounted for 3,197 (41.0%) of the surgeons performing the procedures and operated on 4,488 (1.0%) of the patients. The overall complication rates were 32.0% for patients treated by very low-volume surgeons compared with 9.9% for those treated by other surgeons (P<.001) (adjusted relative risk 1.97, 95% CI 1.86-2.09). Specifically, the rates of intraoperative (11.3% vs 3.1%), surgical site (15.1% vs 4.1%) and medical complications (19.5% vs 4.8%), and transfusion (38.5% vs 11.8%) were higher for very low-volume compared with higher volume surgeons (P<.001 for all). Patients treated by very low-volume surgeons were also more likely to have a prolonged length of stay (62.0% vs 22.0%) and excessive hospital charges (59.8% vs 24.6%) compared with higher volume surgeons (P<.001 for both). Mortality rate was 2.5% for very low-volume surgeons compared with 0.2% for higher volume surgeons (P<.001) (adjusted relative risk 2.89, 95% CI 2.32-3.61).
conclusionA substantial number of surgeons performing hysterectomy are very low-volume surgeons. Performance of hysterectomy by very low-volume surgeons is associated with increased morbidity, mortality, and resource utilization.
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