Surgical Outcomes of Laparoscopic Hysterectomy for Enlarged Uteri

Study ObjectiveTo compare surgical outcomes of laparoscopic hysterectomy for benign diseases according to the uterine weight.DesignRetrospective study (Canadian Task Force classification II-3).SettingTeaching and research hospital, a tertiary center.PatientsWomen undergoing laparoscopic hysterectomy for benign diseases.InterventionsPatients were divided into three groups according to the uterine weight: <250 g (n = 1300), 250 to 500 g (n = 614), and >500 g (n = 178).Measurements and Main ResultsPrimary outcomes were differences in conversion rates, operating time, and blood loss. Secondary outcomes were differences in length of hospital stay, time to first bowel movement, time of bladder catheterization, and complications. Operating time increased according to the uterine weight (116.5 vs 124.1 vs 133 minutes; p <.001). The rate of conversion was statistically higher only for patients with uteri >500 g (3.3% vs 5% vs 13.5%; p <.001). However, the difference between preoperative and postoperative hemoglobin levels was equivalent for the three groups, as well as the overall rates of minor and major intraoperative complications. There was no difference in the time of bladder catheterization, time to first bowel movement, length of hospital stay, and incidence of minor and major postoperative complications among the three groups.ConclusionDespite longer operating time, there is no increase in the intraoperative or postoperative complication rates in those patients with enlarged uteri undergoing laparoscopic hysterectomy. Only conversion is higher in patients with uteri >500 g.