Introduction: One of the greatest achievements in the surgical field is the paradigm shift from open
surgery to minimal invasive surgery. Hysteroscopy, laparoscopy, laparoscopy-assisted vaginal hysterectomy
and total laparoscopic hysterectomy are frequently performed minimal invasive gynecological surgeries.
These surgeries are being regularly performed in Dhulikhel hospital. This study aims to review the
changes in surgical approaches in the field of gynecological surgeries in this institute. Methods: This was a
retrospective study of changes in surgical approaches from conventional to minimal invasive surgery in the
field of gynecological surgeries from 2010 to 2018. Demographic characteristics of patients and indication
for various minimal invasive surgeries were compared over this time period. Results: There were significant
changes in surgical approaches from conventional open surgeries to minimally invasive approach through
the years. There was no obvious difference in demographic characteristics of the cases and the indications for
hysterectomy and endometrial sampling were comparable. Conclusion: There was definitely paradigm shift
in conventional method to minimal invasive methods for major gynecological surgeries like hysterectomy,
ovarian cystectomy, salpingectomy for ectopic pregnancy and endometrial samplings.

Keywords: Ectopic, Endometrial sampling, Hysterectomy, Ovarian cystectomy, Paradigm shift