Design: Retrospective cohort study

Setting: Multi-center, urban academic teaching institution

Patients or Participants: We included all patients who underwent scheduled hysterectomy for benign indications during years 2018 and 2022 and assessed 6-month outcomes. We excluded patients <18 years of age or those undergoing surgery for obstetric indications.

Interventions: Recruitment of FMIGS-trained faculty and increased robotic training for generalists occurred in 2020. The pre-intervention cohort included patients who underwent hysterectomy in 2018 (n=179) and post-intervention cohort included patients who underwent hysterectomy in 2022 (n=247).

Measurements and Main Results: We collected data on 426 patients via the electronic medical record. Patient variables included age, body mass index, American Society of Anesthesiology (ASA) class, prior abdominal/pelvic surgery, uterine weight, estimated blood loss, length of stay, discharge opiate prescription, complications, need for readmission, and surgeon. Preliminary results show that in the pre-intervention cohort, 62 of 112 Black patients (56%) underwent MIH in comparison to 40 of 54 (74%) of white patients and 7 of 13 (54%) of Asian/Other patients. During the post-intervention phase, 114 of 152 (75%) Black patients underwent MIH in comparison to 61 of 74 (82%) of white patients and 19 of 21 (90%) of Asian/Other patients. Between the pre-intervention and post-intervention phase, the number of high-volume minimally invasive surgeons doubled from 3 to 6 (100%). Analyses will adjust for patient factors described above and impact of number of high-volume surgeons using logistic regression and will also compare postoperative outcomes by race.

Conclusion: Disparities between racial minorities and white patients undergoing MIH have decreased at our institution. Increasing recruitment of FMIGs trained faculty and expansion of robotic training may contribute to reducing health disparities in gynecologic surgery.