Technicity in Canada: A nationwide whole population analysis of temporal trends and variation in minimally invasive hysterectomies.

Abstract Study Objective The objective of our study is to provide a contemporary description of hysterectomy practice and temporal trends in Canada. Design A national whole population retrospective analysis of data from the Canadian Institute for Health Information Setting Canada Patients All women who underwent hysterectomy for benign indication from 01/04/2007 to 31/03/2017 in Canada. Interventions Hysterectomy Measurements and Main results A total of 369,520 hysterectomies were performed in Canada during the ten-year period, during which hysterectomy rate decreased from 313 to 243/100,000 women. The proportion of abdominal hysterectomies decreased (59.5% to 36.9%); laparoscopic hysterectomies increased (10.8% to 38.6%); vaginal hysterectomies decreased (29.7% to 24.5%); while the national technicity index increased from 40.5% to 63.1% (p In year 2016/17, women age 40-49 years had significantly increased risk of abdominal hysterectomy compared with women undergoing hysterectomy in other age categories (p Using Ontario as the comparator, Nova Scotia (aRR 1.35, 95%CI[1.27-1.43]), New Brunswick (aRR1.25, 95%CI[1.18-1.32]), Manitoba (aRR1.35, 95%CI[1.28-1.43]) and Newfoundland (aRR1.18, 95%CI[1.10-1.27]), had significantly higher risks of abdominal hysterectomy; whereas Saskatchewan (aRR0.75, 95%CI[0.74-0.77]) and British Columbia (aRR0.86, 95%CI[0.85-0.88]) had significantly lower risks; while Prince Edward Island and Quebec and Alberta were not significantly different. Conclusion Minimally invasive hysterectomy for benign indication has increased significantly in Canada. The declining use of vaginal approaches and the variation between provinces are of concern and necessitate further study.