Statement - Minimal access gynecological surgery

The Challenge:

Worldwide, a vast number of benign gynecologic surgical procedures continue to be performed via laparotomy despite the overwhelming benefits that high quality evidence has shown to be associated with minimal access surgery.  For example, hysterectomy is one of the most common operations performed in women worldwide. 

While laparoscopy and other minimal access surgical techniques have become the most common approach for hysterectomy and other gynecologic surgeries in high-income countries, laparotomy is still frequently used throughout the world. This is despite the fact that minimal access approaches to surgical procedures are associated with decreased morbidity and mortality. 

  • Low-income countries and lower middle-income countries report 0.2-14.7% of all gynecologic surgery is minimally invasive.
  • Complication rates in low-income countries are 0.7-8.3% compared to 0.72-1.7% in upper middle-income countries.

FIGO declares that:

  • All women should have access to high quality, safe and affordable minimally invasive gynecological surgery.
  • Information regarding minimal access surgical techniques should be given priority for every woman when discussing surgical treatment for benign gynecologic conditions.
  • Women need to be empowered to ask their healthcare providers for a less invasive approach to surgery. 
  • Women should be provided with knowledge and guidance to help them become advocates for their gynecologic surgical needs.

FIGO commits to undertake the following actions in our various individual and collective capacities to:

  • Advocate for minimal access surgical techniques for benign gynecologic procedures.
  • Promote and undertake activities to build surgical capacity and expertise by facilitating training of all gynecological surgeons and the entire surgical team in minimally invasive diagnostic and therapeutic techniques.
  • Provide women with the knowledge to make them aware of their options.
  • Increase access to high quality minimal access surgery including both hysteroscopic and laparoscopic techniques for all women.
  • Decrease barriers and disparities in quality of gynecologic surgery worldwide.

About FIGO

FIGO is a professional organisation that brings together obstetrical and gynecological associations from all over the world.

FIGO’s vision is that women of the world achieve the highest possible standards of physical, mental, reproductive and sexual health and wellbeing throughout their lives. We lead on global programme activities, with a particular focus on sub-Saharan Africa and South East Asia.

FIGO advocates on a global stage, especially in relation to the Sustainable Development Goals (SDGs) pertaining to reproductive, maternal, newborn, child and adolescent health and non-communicable diseases (SDG3). We also work to raise the status of women and enable their active participation to achieve their reproductive and sexual rights, including addressing FGM and gender based violence (SDG5).