Introduction: For benign disease, vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) are preferred to abdominal hysterectomy (AH). The Australasian Gynaecology Endoscopy and Surgery Society (AGES) and RANZCOG have published guidelines regarding scope of practice for laparoscopic hysterectomy. We determined trainee's exposure, by mode and complexity, to hysterectomy at our tertiary facility.

Methods: All hysterectomies at the Gold Coast University Hospital between 1/1/17 and 31/12/17 were reviewed. Differentiation criteria were; mode of hysterectomy, operative complexity (AGES Levels of Scope Clinical Practice), operative team (General, Gynae‐Oncology, Urogynaecology) and trainee grade (Training Fellow in Urogynaecology, Gynae‐Oncology, AGES, or General Trainee).

Results: There were 305 hysterectomies; 147 (48%) by general Gynaecology, 119 (39%) by Gynae‐Oncology and 39 (13%) by Urogynaecology. 197 (65%) were LH, 71 (23%) were AH and 37 (12%) were VH. Of the 147 hysterectomies performed under a general team; 4 (3%) were VH, 107 (73%) were LH and 36 (24%) were AH. 206 hysterectomies were performed for presumed benign disease; 129 were LH (63%), 40 (19%) were AH, and 37 (18%) were VH. Of the LH undertaken for presumed benign disease, 87 (67%) were performed by general trainees and 54% of these were graded at least AGES Level 5.

Discussion: At our facility, trainee exposure to LH is more common than to AH or LH. The majority of LH performed were complex (AGES Level 5 or above). Almost all VH were performed by the Urogynaecology team and general trainee exposure to this procedure was limited.