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WASHINGTON (AP) -- 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.

But for routine hysterectomies, the vaginal method lets women leave the hospital just as quickly, without spending nearly as much money, Breeden said Thursday in a statement setting out the position of the nation's largest group of OB/GYNs.

When that's not possible, a laparoscopic hysterectomy - so-called keyhole surgery, operating through a few small incisions in the abdomen - is the second least invasive and costly option, he said.

"It is important to separate the marketing hype from the reality when considering the best surgical approach," Breeden said, adding: "There is no good data proving that robotic hysterectomy is even as good as, let alone better than, existing and far less costly minimally invasive alternatives."

The robotic method is similar to that keyhole operation except the doctor uses a computer to control robotic arms that hold the surgical tools, theoretically easier to move in tight quarters. Breeden said there may be advantages to robotic techniques for "unusual and complex clinical conditions," such as cancer operations that require extensive surgery to find and remove lymph nodes - but that needs additional research.

About 600,000 U.S. women a year undergo a hysterectomy. Traditionally, doctors removed the uterus through a large abdominal incision that meant a long recovery. Today, minimally invasive surgery is encouraged although many women still get the older open surgery for a variety of reasons.

Thursday's statement is sure to prove controversial with doctors who have embraced the technology. But it comes after a major study last month found robotic surgery adds at least $2,000 to the cost of a hysterectomy without improving outcomes. Breeden said another study found surgeons perform 50 to 90 robotic hysterectomies before becoming as good at it as they are with other minimally invasive methods.

Manufacturer Intuitive Surgical Inc. said its da Vinci robot system allows some women who otherwise would need an old-fashioned open hysterectomy - because of obesity, scarring or other complexities - to instead have a smaller operation.

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NEW YORK (AP) -- Health officials are reporting an alarming increase in some dangerous superbugs at U.S. hospitals.

These superbugs from a common germ family have become extremely resistant to treatment with antibiotics. Only 10 years ago, such resistance was hardly ever seen in this group.

Infections from these superbugs are still uncommon. But in the first six months of last year, nearly 200 U.S. hospitals - about 4 percent - saw at least one case, the Centers for Disease Control and Prevent reported Tuesday.

"I would call them a major threat emerging in our hospitals," said Dr. Arjun Srinivasan, an infectious disease expert at the CDC.

Health officials call them "nightmare bacteria" that have now been seen in 42 states and threaten to spread their resistance to more and more of their bacterial brethren.

"We only have a limited window of opportunity to stop spread" of these superbugs, said CDC Director Dr. Tom Frieden. At a press conference Tuesday, he said he was "sounding an alarm."

The CDC urged hospital workers to watch for the infections and take steps to prevent passing the germs to other patients.

The report did not include better-known superbugs like the staph infection MRSA or the intestinal bug known as C-diff, which have plagued hospitals.

It focused on the superbugs that have emerged from one specific bacteria group. At least five of the 70 kinds in that family have developed resistance to a class of antibiotic called carbapenems - considered one of the last lines of defense against hard-to-treat bugs.

Some of those bacteria seem to have terrifying potential. Among them: Klebsiella pneumoniae, a bug that killed at least seven patients at a federal research hospital in Bethesda, Md.; and those made resistant by a gene called NDM-1, named for New Delhi.

The bacteria usually live harmlessly in the gut but can cause pneumonia, and urinary tract and bloodstream infections if they get into other parts of the bodies of patients with weakened immune systems. As many as half the patients who get the bloodstream infections die, Srinivasan said.

However, CDC did not provide figures on deaths attributed to these superbugs.

In 2001, U.S. hospitals reported that only 1 percent of samples from the bacterial family were resistant to the antibiotic carbapenems. By 2011, it had risen to 4 percent.

It was more of an issue in the nation's 400 specialized, long-term hospitals - 18 percent of them reported seeing such a superbug. The Northeast had the most, followed by the South.

U.S. health officials are keeping a close eye on the NDM-1 superbugs, which first showed up in India in 2010 and have been seen as more of a concern in other parts of the world. Of the 30 cases in the U.S., about half have been reported since July, including eight patients at a Denver hospital.

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WASHINGTON (AP) — Lawmakers are pushing for tougher U.S. financial restrictions on North Korea even as the U.N. Security Council moves closer to a new resolution tightening international sanctions in response to Pyongyang's latest nuclear test.

The U.S. is expected to present a draft resolution to the council Tuesday, after reaching agreement with China following three weeks of deliberations on how to respond to the North's third atomic test, U.N. diplomats said.

That's a sign of Beijing's disapproval of its troublesome ally's behavior and will be welcomed in Washington. The text of the resolution has not been made public, but there has been speculation the U.N.'s most powerful body could move to toughen financial restrictions and cargo inspections, as well as blacklisting more companies and individuals.

Earlier Tuesday, North Korea's military vowed to cancel the 1953 Korean War cease-fire, saying Washington and others are going beyond mere economic sanctions and expanding into blunt aggression and military acts. The Korean People's Army Supreme Command also warned that it will block a communications line at the border village separating the two Koreas.

In the U.S., the foreign affairs panels of both houses of Congress will consider the Obama administration's next policy options to impede Pyongyang's development of missile and nuclear weapons that are increasingly viewed as a direct threat to the United States.

On Tuesday, the Republican-led House foreign affairs panel will examine how criminal activities support North Korea's authoritarian regime. That could buttress the case for leveraging the vast reach of the U.S. financial system to pressure international banks that deal with the North.

North Korea long has been believed to have derived hundreds of millions of dollars a year from criminal activities such as counterfeiting of cigarettes and U.S. currency, drug trafficking and insurance scams. Its sales of missiles and conventional weaponry are also outlawed under existing U.N. resolutions.

Targeted U.S. financial sanctions have been tried before and have had a significant impact but upset China, the North's main source of economic support and the country where it conducts most of its trade and financial transactions. The U.S. wants Beijing to exert more pressure on North Korea, and China's willingness to agree to more U.N sanctions shows its patience is wearing thin. It remains to be seen, however, whether diplomatic action on more sanctions translates into their implementation on the ground.

There is deep frustration in Congress over the international diplomatic efforts aimed at persuading Pyongyang to end its nuclear weapons program in exchange for aid. The talks, hosted by China, have been stalled since 2009. A U.S. attempt to offer food aid in exchange for nuclear concessions last year fell flat.

New North Korean leader Kim Jong Un has adopted a confrontational approach toward Washington, although he did deign to meet last week with former professional basketball star Dennis Rodman.

House Foreign Affairs Committee Chairman Ed Royce said that since the Bill Clinton administration, U.S. policy toward North Korea has been a "bipartisan failure" based on the hope that North Korea would do the right thing.

The California Republican said Tuesday's hearing "will identify the best strategy for cutting off North Korea's access to hard currency in order to see real change."

Sung-Yoon Lee, professor of Korea studies at Tufts University, who was scheduled to testify, said the North's "shadowy palace economy" makes the Kim regime vulnerable to actions targeting money laundering. He suggests the Treasury Department require American banks to restrict their dealings with foreign individuals, banks, entities and even entire governments that are linked to North Korea's government.

"The Obama administration has apparently not decided on this approach, but the political climate is conducive to trying something like it," Lee said.

Marcus Noland, an expert on North Korea's economy at the Peterson Institute for International Economics, said the North's illicit activities continue, although their overall importance for the North's economy has declined as its international trade, particularly with China, has grown sharply. China accounts for 70 percent to 80 percent of North Korea's trade and totaled more than $7 billion in 2011.

In a rough estimate, Noland estimated that arms and illicit exports accounted for just under 10 percent of the merchandise the North traded in 2011, compared with more than 30 percent in 1999, when the economy was at a low point after years of famine. International interdiction efforts have also impeded the illicit trade, he said.

The North's improved financial standing could help explain its recent provocative behavior in conducting rocket and nuclear tests.

"If you are running a surplus and China is in your corner and won't implement U.N. embargos, then you can be provocative," Noland said. "But North Korea is heavily dependent on China, particularly for energy, and if China changes policy and literally cuts off the pipeline, then they're in real trouble."

In 2005, the U.S. Treasury sanctioned Banco Delta Asia, a bank in the Chinese territory of Macau which held about $25 million in North Korean funds. Treasury accused the bank of introducing counterfeit notes and laundering funds on behalf of North Korean enterprises linked to weapons of mass destruction programs.

The 2005 action caused a ripple effect among other banks worried about being closed out of the international financial system. Yet the sanction annoyed Beijing — as well as enraging Pyongyang — and proved complicated to undo when nuclear negotiations with North Korea finally got back on track.

The U.S. could also target the North's shipping by declaring the country a criminal enterprise, making vessels carrying its goods difficult to insure and subject to search and seizure, Noland said.

Associated Press writer Edith Lederer at the United Nations contributed to this report.