Related Experiment Video
Updated: Feb 19, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Laparoscopic Single-Incision Supracervical Hysterectomy for an Extremely Large Uterus with Bag Tissue Extraction
Xiaoming Guan1, Juan Liu2, Yanzhou Wang3
1Baylor College of Medicine, Houston, Texas; Guangzhou Medical University, Guangzhou, Guangdong, China.
Objective:
To describe and demonstrate the single-incision laparoscopic technique with an articulated energy device for a uterus larger than 20 cm.
Design:
Stepwise demonstration of the single-site surgical technique and tissue extraction with narrated video footage (Canadian Task Force classification III).
Setting:
Single-incision laparoscopic hysterectomy can be difficult because of the long operating time, steep learning curve, and need for articulated instruments, and it is especially challenging in patients with a uterus larger than 20 cm. However, the advantages of single-site laparoscopic surgery may include less bleeding, infection, and pain and a better cosmetic outcome.
Interventions:
A 49-year-old G3P3 female with a 24 weeks-sized fibroid uterus requesting supracervical hysterectomy presented to our tertiary academic medical center with a 2-year history of pelvic pain and menorrhagia with a normal Pap smear history. Uterine weight was 1900 g. Laparoscopic single-incision supracervical hysterectomy with contained bag tissue extraction was performed. Rotating between the patient's right and left side allowed the surgeon to access the entire abdomen from a single umbilical port. There was no complications or conversions to multiport in the surgery.
Conclusion:
Single-incision laparoscopic hysterectomy for a uterus larger than 20 cm is possible and leads to better outcomes.
