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Book and Media Reviews
May 16, 2007

Advances in Reconstructive Vaginal Surgery

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Fishbein Fellow.

JAMA. 2007;297(19):2141-2144. doi:10.1001/jama.297.19.2142

Vaginal surgery is a skill distinctive to the gynecologic surgeon, with a tradition that dates back nearly 2 centuries. Proficiency in the performance of vaginal hysterectomy and basic pelvic reconstructive procedures is a fundamental component of gynecologic residency training. By most accounts, vaginal hysterectomy is associated with the fastest recovery, lowest morbidity, and lowest cost of all hysterectomy procedures, yet nearly 75% of all hysterectomy procedures in the United States are performed via the abdominal route. Moreover, marketers of laparoscopic instrumentation have tacitly fostered a belief that bilateral salpingo-oophorectomy cannot be accomplished at the time of vaginal hysterectomy without laparoscopic assistance (despite longer operating times, additional costs, and higher complication rates associated with laparoscopic-assisted and total laparoscopic hysterectomy.) In this atmosphere of ambiguity and industry-inspired gimmickry, I approached this book by Robert Kovac and Carl Zimmerman with curious interest.

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