title: Is laparoscopic hysterectomy feasible for uteri larger than 1000 g?
abstract: OBJECTIVE
  To evaluate the feasibility of laparoscopic hysterectomy for uteri weighing more than 1000 g.
  
  
  METHODS
  A retrospective study was conducted in a tertiary center of laparoscopic surgery including 38 women submitted to hysterectomy for uteri weighing more than 1000 g. Patients submitted to open hysterectomy were compared to those submitted to laparoscopic hysterectomy. The primary statistical endpoint was the complication rate. Secondary endpoints were operating time, estimated blood loss, length of hospital stay, and conversion to laparotomy.
  
  
  RESULTS
  The patients' mean age was 49.4 years and mean BMI was 25.2 kg/m(2). The surgical intent was laparoscopic hysterectomy in 23 patients (60.5%) and laparotomy in 15 patients (39.5%). Conversion to open surgery was required in 4 patients (17.4%) due to inaccessibility of the pelvis at the beginning of surgery (n=2), technical difficulties during surgery (n=1), and intraoperative bleeding (n=1). One patient in the laparotomy group had an intraoperative ureteral injury. Despite longer operative time (130 vs. 80 min, p=0.002), laparoscopic surgery was associated with reduced length of hospital stay (3 vs. 6 days, p<0.001). Intraoperative bleeding was evaluated by the difference of pre- and post-operative hemoglobin and was equivalent in both groups (2.2 vs. 1.6g/dL; p=0.84). There was a tendency for more postoperative complications in the laparotomic group (33.4% vs. 8.7%; p=0.05).
  
  
  CONCLUSIONS
  Laparoscopic hysterectomy is feasible for selected patients with uteri weighing more than 1000 g.
authors.affiliation: Department of Gynecologic Surgery, CHU Estaing, 1 Place Lucie Aubrac, 63003 Clermont-Ferrand, France. williamkondo@yahoo.com
authors.forename: William
authors.initials: W
authors.lastname: Kondo
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bourdel
authors.forename: Francesca
authors.initials: F
authors.lastname: Marengo
authors.forename: Revaz
authors.initials: R
authors.lastname: Botchorishvili
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Pouly
authors.forename: Kris
authors.initials: K
authors.lastname: Jardon
authors.forename: Benoit
authors.initials: B
authors.lastname: Rabischong
authors.forename: Gérard
authors.initials: G
authors.lastname: Mage
authors.forename: Michel
authors.initials: M
authors.lastname: Canis
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014599:Uterus / Q000473:pathology*