Laparoscopic subtotal hysterectomy for large uteri using modified five port technique

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Surgical Techniques
• Uterine Pathology

Background:

• Large uteri present surgical challenges in hysterectomy.
• Laparoscopic subtotal hysterectomy (LASH) is an alternative to open procedures.
• Optimizing laparoscopic techniques for large uteri is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the outcomes of laparoscopic subtotal hysterectomy (LASH) in women with large uteri.
• To assess the efficacy and safety of a modified five-port technique for LASH.
• To determine the feasibility of this technique in managing symptomatic large uteri.

Main Methods:

• Prospective cohort study of 29 women with uteri >300g undergoing LASH.
• Utilized a modified five-port technique for laparoscopic subtotal hysterectomy.
• Data analyzed for operative time, blood loss, complications, and hospital stay.

Main Results:

• Mean operative time was 84 minutes with median blood loss of 200 ml.
• One major complication (bladder injury) occurred, managed intraoperatively.
• Mean hospital stay was 2 days; no cases required conversion to laparotomy.

Conclusions:

• The modified five-port LASH technique provides excellent operative field exposure for large uteri.
• This technique improves procedural efficiency and ease.
• It offers cosmetic benefits with a low complication rate.