The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic techniques for hysterectomy.
Hysterectomy is the surgical removal of the uterus. This may be used to treat women with various conditions including chronic pelvic pain, heavy periods, fibroids, or cancer of the uterus or the ovaries. Conventional hysterectomy is performed through an incision in the abdomen or through the vagina. In laparoscopic techniques for hysterectomy, special surgical instruments are inserted through small incisions made in the abdomen, and the operation is carried out with the aid of an internal telescope and camera system. This is sometimes described as 'keyhole surgery'. Part of the operation may also be performed vaginally.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.