title: Evaluation of the surgical outcome and complications of total laparoscopic hysterectomy in patients with enlarged uteruses.
abstract: OBJECTIVE
  The aim of this study was to investigate whether uterine weight has a deleterious effect on the operation time, complication rates, length of hospital stay and incidence of intraoperative haemorrhage during total laparoscopic hysterectomy operation.
  
  
  METHODS
  A total of 282 patients who underwent total laparoscopic hysterectomy for benign gynaecologic indications were retrospectively analyzed. The median operation time of 70 min was accepted as an index number, and a cut-off point of ≥300 g was calculated for uterine weight by using reciever operator characteristics (ROC) curve analysis.
  
  
  RESULTS
  There was no statistically significant relationship between the uterine weight and haemoglobin drop rate (1.27 ± 0.89 vs 1.21 ± 0.88, p = 0.905), complication rate (10.83% vs 9.26%, p = 0.062) and length of hospital stay (3.27 ± 1.23 vs 3.37 ± 1.35 days, p = 0.505) based on this cut. Lee-Huang point was preferred for abdominal entry in cases with uteruses reached the level of umbilicus -2 cm in physical examination.
  
  
  CONCLUSIONS
  Uterine weight was not effected the complication rate, estimated blood loss and length of hospital stay in total laparoscopic hysterectomy operation. A cut-off value of 300 g could be used for an increased operation time.
authors: Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors: Hasan
authors: H
authors: Terzi
authors: Department of Obstetrics & Gynecology, Celal Bayar University School of Medicine, Manisa, Turkey.
authors: Pinar Solmaz
authors: PS
authors: Hasdemir
authors: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: bileralper@gmail.com.
authors: Alper
authors: A
authors: Biler
authors: Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors: Ahmet
authors: A
authors: Kale
authors: Department of Obstetrics & Gynecology, Acibadem University School of Medicine, Istanbul, Turkey.
authors: Fatih
authors: F
authors: Sendag
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D009929:Organ Size; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*
keywords: Complications; Laparoscopy; Large uterus; Total laparoscopic hysterectomy; Uterus weight