View all recommendations from this society

November 15, 2017; Updated October 11, 2019

Avoid laparotomy for the management of non-malignant disease when surgery is indicated and a minimally invasive approach such as hysteroscopy, vaginal laparoscopy or robotic-assisted surgery is feasible and appropriate.

Selection of a minimally invasive approach should be tailored to patient selection, surgeon ability, and equipment availability. The surgeon should take into consideration how the procedure may be performed cost-effectively with the fewest complications and refer to subspecialists to provide optimal outcomes.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physicians.

How The List Was Created

As an international leader in the advancement of minimally invasive surgery, AAGL relies on its society members and board to determine the various needs and best practices to promote safe, higher quality care to patients. The list of things to question provided to the Choosing Widely campaign was submitted to the AAGL Board, who developed a subcommittee dedicated to analyzing the recommended interventions. The subcommittee of expert surgeons in the field of minimally invasive surgery recommended and developed a more effective use of health care resources, along with safe techniques to practice. The submitted list was reviewed and approved by the AAGL Board.


Gala R et al. Systematic Review of Robotic Surgery in Gynecology: Robotic Techniques Compared with Laparoscopy and Laparotomy, J Minim Invasive Gynecol. 2014 May-Jun;21(3):353-61.

ACOG Committee Opinion: Choosing the Route of Hysterectomy for Benign Disease, Number 701, June 2017