Laparoscopically assisted hysterectomy for uteri weighing 500 g or more

Pelosi, Marco A.; Kadar, Nicholas

doi:10.1016/s1074-3804(05)80808-4

Cited by 60 publications

(23 citation statements)

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“…Pelosi and Kadar reported a series including 20 patients whose uterus weighed > 500 g, who underwent LAVH, and only one case of bleeding requiring blood transfusion [9]. Chang et al, compared surgical outcomes between large and small uteruses, with 750 g as the cut-off point, and found that the operative time, blood loss, and transfusion requirement, were significantly increased in the large uterus group.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopically-assisted vaginal hysterectomy for enlarged uterus: operative outcomes and the learning curve

Dolanbay

Kütük²,

Özgün³

et al. 2016

Ginekol Pol

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Objectives: The aim of the study was to compare the effects of uterine size and surgeon experience on the surgical outcomes of laparoscopically-assisted vaginal hysterectomy (LAVH) for benign gynecological conditions. Material and methods:This was a retrospective analysis of 184 LAVH cases. All hysterectomies were performed by the same surgeon and divided into two groups, with uterine weight of < 280 g (group 1) and uterine weight of > 280 g (group 2). The groups were compared in terms of the effects of the uterine size and surgeon experience vs. the operative outcomes (operative time, change in hemoglobin levels, hospital stay, and perioperative complications).Results: No significant differences in mean age, parity, history of chronic systemic diseases and previous surgery history were observed between the two groups. However, operative time was significantly greater in group 2 as compared to group 1 (132.1 ± 42.7 minutes vs. 111.5 ± 30.4 minutes, p < 0.05). There were no differences in the hospital stay and perioperative complications between the two groups. One case of bladder injury occurred in each group and one patient underwent a second laparoscopic surgery for postoperative bleeding in group 2. Greater surgeon experience was demonstrated to be associated with decreased operative bleeding and, consequently, smaller differences between preoperative and postoperative hemoglobin levels. Operative time was also reduced as the surgeon was getting more experienced but the effect did not reach statistical significance. Conclusions:Our study supports the thesis that LAVH is a safe and effective procedure for managing benign gynecological conditions. Despite increased operative time, LAVH can be safely performed for enlarged uterus in conjunction with increased surgeon experience.

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Section: Discussionmentioning

confidence: 99%

Laparoscopically-assisted vaginal hysterectomy for enlarged uterus: operative outcomes and the learning curve

Dolanbay

Kütük²,

Özgün³

et al. 2016

Ginekol Pol

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“…Nine cases of laparoscopic hysterectomy for uterine fibroid masses have been reported as part of larger series [11,12,13]. Uterine vessels were secured using bipolar coagulation in six cases [11,13], and laparoscopic suture ligation in three [12]; no complications were reported.…”

Section: Discussionmentioning

confidence: 99%

“…Uterine vessels were secured using bipolar coagulation in six cases [11,13], and laparoscopic suture ligation in three [12]; no complications were reported. O'Shea et al [14] reported the first large series (21 cases) of laparoscopic hysterectomies (where the uterine vessels are secured trans-abdominally [3]) for large uterine fibroid masses with a mean weight of 534.7 g (range 390-1,022 g).…”

Section: Discussionmentioning

confidence: 99%

“…Also, with large uterine fibroid masses, surgical access is limited, and surgeons are forced to work closer to the pelvic sidewalls, thus increasing the risk of ureteric injury. Individual cases of large uterine fibroid masses removed by laparoscopic hysterectomy have been reported as part of larger series with varied techniques [11,12,13]. Two series of laparoscopic hys-terectomy for large uterine fibroid masses have been reported [10,14].…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic stapling of large uterine vessels at laparoscopic hysterectomy for uterine fibroid masses of 500 g or more: a pilot study

McMaster-Fay

2004

Gynecol Surg

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From December 1996 to March 2004, 27 consecutive patients (both private and public) presented with large uterine fibroid masses to be removed, which subsequently weighed 500 g or more. All were scheduled for a laparoscopic hysterectomy procedure where the uterine vessels are secured laparoscopically using a linear cutterstapling device. The data from these cases was collected prospectively. Twenty-six of the large uterine fibroid masses were successfully removed by planned laparoscopic hysterectomy without major complication. One case had to be opened because of dense pelvic adhesion, and it was the case with the largest mass in the series (1,280 g). The mean weight of the removed masses was 704.6 g (range: 500-1,280 g). Operating times were long (mean 220 min), but the postoperative stay was short (mean 2.26 days). Laparoscopic hysterectomy a using linear cutter-stapling device to secure the uterine vessel pedicles for large uterine fibroid masses is a useful and effective procedure in most cases with fast patient recovery.

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“…The laparoscopic hysterectomy for large fibroid is known to be difficult surgeries with long operating time, increased blood loss sometimes requiring blood transfusion or conversions to open laparotomy [10][11][12].…”

Section: A Laparoscopic Assisted Minilaparotomy Hysterectomy Approachmentioning

confidence: 99%

A Laparoscopic Assisted Minilaparotomy Hysterectomy approach for Very Large Fibroid Uteri of more than 1000 grams – A Preliminary Study

Wong¹

2015

Journal of Gynecology Research

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Objective: To report the surgical outcome of a laparoscopic assisted minilaparotomy hysterectomy (LMH) surgical approach for the management of very large fibroid uteri. [5][6][7][8][9]. However, this minilaparotomy approach might still be considered difficult for the very large fibroid uteri because of the difficulty to assess the sizes and locations of fibroids, presence of adhesions and the iceberg phenomenon of the large fibroid uterus within the pelvis. Introduction A Laparoscopic Assisted Minilaparotomy Hysterectomy approach for Very Large Fibroid Uteri of more than 1000 grams -A PreliminaryOn the other hands, some laparoscopists would also find hysterectomy for very large fibroid uteri difficult to perform. The laparoscopic hysterectomy for large fibroid is known to be difficult surgeries with long operating time, increased blood loss sometimes requiring blood transfusion or conversions to open laparotomy [10][11][12].Setting: A private hospital, St. Paul's Hospital, in Hong Kong Patients and Surgical techniques:It is a retrospective study to assess a hysterectomy approach for very large fibroid uteri of more than 1000 grams. This paper described the surgical technique of this hysterectomy approach and presented the patient characteristics, surgical data and clinical outcome.Result: From 2011 to 2014, 13 women underwent a surgical approach of laparoscopic assisted minilaparotomy hysterectomy with or without salpingo-oophorectomy (LMH +/-SO) for very large fibroid uteri larger than 1000 grams. All hysterectomies were successfully completed without intraoperative or postoperative complication. The amount of blood loss was comparatively less than that of abdominal hysterectomy for very large fibroid uteri reported in the literature. All patients recovered well after operation and many had an early discharge from hospital. Conclusion:In conclusion, this surgical approach for hysterectomy can replace open abdominal hysterectomy for very large fibroid uteri more than 1000 grams. The technique is a combination of laparoscopy and minilaparotomy hysterectomy. It is a safe and feasible alternative as a minimally invasive surgery for very large fibroid uteri.

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Laparoscopically assisted hysterectomy for uteri weighing 500 g or more

Cited by 60 publications

References 6 publications

Laparoscopically-assisted vaginal hysterectomy for enlarged uterus: operative outcomes and the learning curve

Laparoscopically-assisted vaginal hysterectomy for enlarged uterus: operative outcomes and the learning curve

Endoscopic stapling of large uterine vessels at laparoscopic hysterectomy for uterine fibroid masses of 500 g or more: a pilot study

A Laparoscopic Assisted Minilaparotomy Hysterectomy approach for Very Large Fibroid Uteri of more than 1000 grams – A Preliminary Study

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