Influence of COVID-19 in Selection of Route of Hysterectomy in Benign Disease

STUDY OBJECTIVE: The objective of this study is to show how prioritizing minimally invasive surgical routes during the COVID 19 allowed our gynecology department to continue performing surgery during operational shutdowns during the pandemic. DESIGN: This is a retrospective chart review study of all patients who underwent hysterectomy for a benign indication between July 1, 2020, and Feb 28, 2021. SETTING: NA. PATIENTS OR PARTICIPANTS: Charts of all patient's undergoing hysterectomy for benign disease between July 1, 2020, and Feb 28, 2021, were reviewed. Patients were excluded if they underwent hysterectomy for malignancy. INTERVENTIONS: Between July 2020 and Feb 2021 out institution experienced two operational shutdowns. The first operational shutdown was July through August 2020 and the second was January through February 2021. During both shutdowns our department had limited operating room availability. During the second shutdown we moved the majority of our minor cases to outpatient ambulatory surgery centers and prioritized cases than could be performed laparoscopically and vaginally. MEASUREMENTS AND MAIN RESULTS: During our chart review we collected information including age, race, BMI, route of hysterectomy, comorbidities (including need for transfusion due to abnormal uterine bleeding), length of surgery, estimated blood loss, weight of uterus reported by pathology, length of hospital stay, and complications for all patient undergoing hysterectomy in the between July 1, 2020, and February 28, 2021, at University Hospital. CONCLUSION: In conclusion utilization of ambulatory surgery centers for our minor cases and prioritizing vaginal and laparoscopic approach to benign hysterectomy allowed our department to double the number of hysterectomies we were able to perform during our 2(nd) COVID-19 shutdown.