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Updated: Feb 12, 2026
05:21
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
518
Laparoscopic hysterectomy for large uteri: Outcomes and techniques
Rooma Sinha1, G Swarnasree1, B Rupa1
1Department of Gynecology, Apollo Health City, Hyderabad, Telangana, India.
Journal of Minimal Access Surgery
|March 28, 2018
Summary
Laparoscopic hysterectomy is a safe and feasible procedure for large uteri, with conversion to open surgery linked to hemorrhage and bladder injury. Experienced surgeons can perform this minimally invasive surgery effectively.
Area of Science:
- Minimally Invasive Surgery
- Gynecologic Oncology
- Surgical Outcomes
Background:
- Laparoscopic hysterectomy for large uteri presents unique surgical challenges.
- Assessing perioperative outcomes and conversion factors is crucial for optimizing patient care.
Purpose of the Study:
- To analyze perioperative outcomes of laparoscopic hysterectomy for uteri >16 weeks.
- To identify factors influencing conversion to open surgery.
- To describe techniques for successful minimally invasive hysterectomy in large uteri.
Main Methods:
- A 5-year retrospective chart review of 128 patients undergoing laparoscopic hysterectomy for large uteri.
- Data collected included demographics, pre-operative and post-operative parameters, intra-operative conversions, and complications.
- All surgeries were performed by a single senior surgeon.
Main Results:
- Laparoscopic hysterectomy was feasible in large uteri (average size 17.5 weeks), with a 10.9% conversion rate to open surgery.
- Conversion was significantly correlated with excessive hemorrhage and bladder injury.
- Average operating room time was 107 minutes, with a 2-day hospital stay and minimal hemoglobin drop.
Conclusions:
- Laparoscopic hysterectomy is a technically feasible and safe option for large uteri.
- Experienced surgeons can perform the procedure with low morbidity, irrespective of fibroid size or location.
- A learning curve of approximately 50 cases is suggested for proficiency.
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