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WASHINGTON — Pricey robotic surgery shouldn’t be the first or even second choice for most women who need a hysterectomy, says advice issued Thursday to doctors who help those women decide. The preferred method: Operate through the vagina, using standard tools rather than a robot, said Dr. James Breeden, president of the American College of Obstetricians and Gynecologists. Increasingly, women are seeing ads that say a robot could help their doctor perform a hysterectomy more easily. And Breeden said doctors are reporting patients who demand that approach or say they’ll take their business elsewhere.

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