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Updated: Jan 28, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Vaginal or laparoscopic hysterectomy: Do perioperative outcomes differ? A propensity score-matched analysis
Doortje Rademaker1,2, Jon I Einarsson1, Judith A F Huirne2
1Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.
Laparoscopic hysterectomy (LH) shows lower blood loss and shorter hospital stays compared to vaginal hysterectomy (VH). This minimally invasive approach is favored for benign hysterectomy when appropriate.
Area of Science:
- Gynecology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Vaginal hysterectomy (VH) is often considered preferred for minimally invasive hysterectomy.
- Laparoscopic hysterectomy (LH) rates are increasing, while VH rates remain stable.
Purpose of the Study:
- To compare perioperative outcomes between laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH).
Main Methods:
- Retrospective review of women undergoing LH or VH for benign indications (2009-2015).
- Propensity score-matched analysis to control for patient differences.
- Outcomes assessed: complications, operative time, blood loss, hospital stay, conversion, and readmission.
Main Results:
- LH demonstrated significantly lower blood loss (102.8 mL vs. 185.0 mL) and shorter hospital stays (0.9 days vs. 1.2 days).
- Concomitant adnexal surgery was more frequent with LH (47.7%), while prolapse surgery was more common with VH (68.4%).
- No significant differences in most intraoperative and postoperative characteristics were observed between the matched groups.
Conclusions:
- Both VH and LH offer favorable perioperative outcomes.
- LH is associated with reduced blood loss and shorter hospital stays.
- The findings support the increasing adoption of laparoscopic hysterectomy for appropriate cases.
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