Korean J Obstet Gynecol.  2010 Jan;53(1):53-57. 10.5468/kjog.2010.53.1.53.

Comparison of morbidity by uterine weight in total laparoscopic hysterectomy

• Kwon HJ
• Kim EO
• Kang JY
• Choi GJ
• Kim HB
• Park SH

• KMID: 2077960
• DOI: http://doi.org/10.5468/kjog.2010.53.1.53

Abstract

OBJECTIVE
To evaluate the effect of uterine weight on short-term outcome of total laparoscopic hysterectomy (TLH) for benign gynecological conditions.
METHODS
A retrospective medical records review of 265 cases of patients with TLH was performed. Patients included in this study underwent TLH as benign uterine disorders at Kangnam Sacred Heart Hostpital, Hallym University from January 2008 through June 2009. These patients were stratified into three groups; Group 1 patients with uterus weighing less than 180 g (n=60), Group2 patients with uterus weighing 180 g to 350 g (n=141), Group 3 patients with uterus weighing more than 350 g (n=64). The groups were compared as regard postoperative stay, operative time, estimated blood loss, hemoglobin change, conversion to open surgery, and postoperative complications.
RESULTS
There was no significant difference in age, gravidity, body mass index, previous pelvic surgery and past medical history. The overall complication rates were not significantly different. But operative time prolonged as uterine weight increased.
CONCLUSION
The TLH can be performed successfully in case of enlarged uterus. Therefore the enlarged uterus is not an absolute contraindication for TLH.

Keyword

Total laparoscopic hysterectomy; Uterine weight; Morbidity

MeSH Terms

Body Mass Index
Conversion to Open Surgery
Gravidity
Heart
Hemoglobins
Humans
Hysterectomy
Medical Records
Operative Time
Retrospective Studies
Uterus
Hemoglobins

Reference

1. Reich H, DeCaprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg. 1989. 5:213–216.

2. Wattiez A, Soriano D, Cohen SB, Nervo P, Canis M, Botchorishvili R, et al. The learning curve of total laparoscopic hysterectomy: Comparative analysis of 1647 cases. J Am Assoc Gynecol Laparosc. 2002. 9:339–345.

3. Reich H, Maher PJ, Wood C. Laparoscopic hysterectomy. Baillieres Clin Obstet Gynaecol. 1994. 8:799–815.

4. Boike GM, Elfstrand EP, DelPriore G, Schumock D, Holley HS, Lurain JR. Laparoscopically assisted vaginal hysterectomy in a university hospital: Report of 82 cases and comparison with abdominal and vaginal hysterectomy. Am J Obstet Gynecol. 1993. 168(6 Pt 1):1690–1697.

5. Davies A, Hart R, Magos A, Hadad E, Morris R. Hysterectomy: Surgical route and complications. Eur J Obstet Gynecol Reprod Biol. 2002. 104:148–151.

6. Garry R. The future of hysterectomy. BJOG. 2005. 112:133–139.

7. Kovac SR, Barhan S, Lister M, Tucker L, Bishop M, Das A. Guidelines for the selection of the route of hysterectomy: Application in a resident clinic population. Am J Obstet Gynecol. 2002. 187:1521–1527.

8. Bonilla DJ, Mains L, Whitaker R, Crawford B, Finan M, Magnus M. Uterine weight as a predictor of morbidity after a benign abdominal and total laparoscopic hysterectomy. J Reprod Med. 2007. 52:490–498.

9. Heinberg EM, Crawford BL 3rd, Weitzen SH, Bonilla DJ. Total laparoscopic hysterectomy in obese versus nonobese patients. Obstet Gynecol. 2004. 103:674–680.

10. Olsson JH, Ellstrom M, Hahlin M. Cost effectiveness and health status after laparoscopic and abdominal hysterectomy. J Am Assoc Gynecol Laparosc. 1996. 3:4 Supplement. S37.

11. Phillips G, Garry R. Techniques of partial hysterectomy: An overview. Zentralbl Gynakol. 1995. 117:625–628.

12. Munro MG, Deprest J. Laparoscopic hysterectomy: Does it work?: A bicontinental review of the literature and clinical commentary. Clin Obstet Gynecol. 1995. 38:401–425.

15. Feroze RM. Vaginal hysterectomy and repair. Clin Obstet Gynaecol. 1978. 5:545–556.

16. Wattiez A, Soriano D, Fiaccavento A, Canis M, Botchorishvili R, Pouly J, et al. Total laparoscopic hysterectomy for very enlarged uteri. J Am Assoc Gynecol Laparosc. 2002. 9:125–130.

17. Fiaccavento A, Landi S, Barbieri F, Zaccoletti R, Tricolore C, Ceccaroni M, et al. Total laparoscopic hysterectomy in cases of very large uteri: A retrospective comparative study. J Minim Invasive Gynecol. 2007. 14:559–563.

18. Ng CC, Chern BS. Total laparoscopic hysterectomy: A 5-year experience. Arch Gynecol Obstet. 2007. 276:613–618.

20. Walsh CA, Walsh SR, Tang TY, Slack M. Total abdominal hysterectomy versus total laparoscopic hysterectomy for benign disease: A meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2009. 144:3–7.