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Updated: Jun 12, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
An intention-to-treat study of total laparoscopic hysterectomy
Richard L Heaton1, M Sami Walid
1Heart of Georgia Women's Center, Warner Robins, GA 31099, USA. riclheaton@yahoo.com
Objective:
To present the experience of a single provider with total laparoscopic hysterectomy (TLH) for benign gynecological pathology in order to promote awareness of the feasibility and merits of this minimally-invasive procedure.
Methods:
An intention-to-treat prospective study was conducted in a suburban gynecological practice in Central Georgia, USA. The study data were collected over a 7-year period.
Results:
From March 2003 to December 2009, 623 total laparoscopic hysterectomies including 379 pure laparoscopic hysterectomies (without additional procedures) were performed and 12 patients were referred to a gyn-oncologist. The majority of our patients (93.6%) had a uterine weight of less than 500 g. The median operative time was 60 minutes for pure total laparoscopic hysterectomies. There were 14 intraoperative organ injuries of which 13 were repaired intraoperatively and no returns to the operation room within the first 24 hours. The average hospital charges for TLH were US $13,468 with an average length of stay of 1 day. The average charges for total abdominal hysterectomy were US $12514 with an average length of stay of 2.3 days.
Conclusion:
An advanced laparoscopist can replace the majority of inpatient total abdominal hysterectomies performed for benign indications with outpatient total laparoscopic hysterectomy.
