title: Total laparoscopic hysterectomy without uterine manipulator at big uterus weight (>280 g).
abstract: METHODS
  The retrospective study included the total laparoscopic hysterectomy without uterus manipulator at big uterus >280 g (Group A), proceeding the same technique as known to show feasibility and safety of its technique, compared with a randomized patient group of a uterus weight below 280 g (Group B). Statistical measurement was proceeded in typical clinical parameters.
  
  
  RESULTS
  No statistical differences in age, body mass index, further abdominal surgery, blood loss, and hospital stay were observed. Operating time was significantly different favouring the uterus below 280 g (111.74 min Group A/90.68 min Group B). No increase in intra- or postoperative complications in both groups was observed.
  
  
  CONCLUSIONS
  Total hysterectomy at big uterus (>280 g) is safe and feasible. Statistical analysis shows a significant shorter operating time only in one parameter (Group B). The technique of hysterectomy without uterus manipulator offers a surgical advancement also at vaginal stenosis, early staged cervix, or endometrial cancer and exhibits an opportunity for laparoscopic advancement in these cases too.
authors.affiliation: Department for Gynecology and Obstetrics, University of Schleswig-Holstein, Luebeck, Germany.
authors.forename: Imke
authors.initials: I
authors.lastname: Mebes
authors.forename: Klaus
authors.initials: K
authors.lastname: Diedrich
authors.forename: Constanze
authors.initials: C
authors.lastname: Banz-Jansen
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D013997:Time Factors; D014599:Uterus / Q000473:pathology* / Q000601:surgery*