While it is true that 75% of the 590,000 hysterectomies each year performed in the U.S. used the abdominal approach, multiple studies and the American College of Obstetrics and Gynecology state that the majority of hysterectomies should be performed by the vaginal approach. These same studies have shown that the decision to perform a hysterectomy abdominally or vaginally has more to do with the training and experience of the surgeon than the condition for which the procedure is being performed. American College of Obstetrics & Gynecology (ACOG) Committee Opinion #311 April 2005.