Hysterectomy for oncological and non-oncological reasons in patients over 70 years of age - comparison of robot-assisted, laparoscopic, and open approaches.

Surgical treatment in patients over the age of 70 presents distinct challenges due to a combination of their overall health status and age-related physiological changes. Hysterectomy remains one of the most frequently performed surgeries in women. Advancements in surgical techniques, especially the introduction of minimally invasive surgery (MIS), which facilitated the development of laparoscopic and robotic-assisted hysterectomy, have transformed the standard of care. This study aims to evaluate the use of different hysterectomy techniques-both for oncologic and non-oncologic indications-in women over the age of 70, as well as in younger cohorts. The study group consisted of 213 patients who underwent hysterectomy at the Department of Obstetrics, Gynaecology, and Gynaecologic Oncology of the Regional Polyclinical Hospital in Grudziadz, Poland, between July 2022 and April 2025. The average age of the patients was 61.4 years; the youngest patient was 34 years old, and the oldest was 87 years old. The target group consisted of 56 patients (26.2%) aged 70 and over, and the comparison group consisted of 157 patients (73.8%) under 70 years of age. In conclusion, our findings affirm the safety and effectiveness of MIS hysterectomy, especially for women over 70 years of age. With low complications and reoperation rates, these techniques represent a preferable option in this age group. Successful outcomes depend on surgical expertise and a tailored approach that addresses each patient's unique needs, anatomy, and medical profile. Furthermore, the implementation of advanced robotic systems, such as the Versius platform, marks a significant advancement in gynaecologic surgery.