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Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure

Received: 16 July 2022    Accepted: 1 August 2022    Published: 10 August 2022
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Abstract

Objective: To compare the outcome of patients with uteri > 250 gm who had minimally invasive hysterectomy (MIH) to those who had abdominal hysterectomy (AH) using the LigaSure, stratify complications based on the uterine weight and report follow-up of patients who had vaginal morcellation. Study Design: A retrospective cohort study comparing patients with uteri > 250 gms who underwent vaginal hysterectomy (VH), laparoscopically assisted vaginal hysterectomy (LAVH) and robotic total laparoscopic hysterectomy (RTLH) to those who underwent AH. In both groups the LigaSure was used. Patients who had vaginal morcellation were followed-up. Results: A total of 166 patients were included: 10 patients had VH, 81 patients had LAVH, 22 patients had RTLH, and 53 patients had AH. Six (5%) MIH were converted to AH. Sixty-four percent of patients who needed hysterectomy were able to have successful MIH. Both groups were similar regarding age, American Society of Anesthesiologists score, previous laparotomy, previous C sections, body mass index, estimated blood loss, operative and postoperative complications, and final pathology report. The conversion and complication rates increased with uterine weight > 1000 gm. Patients who had AH had larger uteri and stayed in the hospital longer than those who had MIH. Thirty patients had vaginal morcellation with no consequences. Conclusion: Most patients with a large uterus could have save MIH with shorter hospital stay. Conversion and complications increase for uteri larger than 1000 gm. Vaginal morcellation had no consequences and the use of LigaSure provided adequate hemostasis.

Published in Journal of Gynecology and Obstetrics (Volume 10, Issue 4)
DOI 10.11648/j.jgo.20221004.17
Page(s) 203-210
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Hysterectomy, Minimally Invasive, Laparoscopic, Robotic, Uterine Weight, Large Uterus

References
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Cite This Article
  • APA Style

    Gamal Hassan Eltabbakh, Samantha Gregoire, Georgia Danine Eltabbakh. (2022). Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure. Journal of Gynecology and Obstetrics, 10(4), 203-210. https://doi.org/10.11648/j.jgo.20221004.17

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    ACS Style

    Gamal Hassan Eltabbakh; Samantha Gregoire; Georgia Danine Eltabbakh. Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure. J. Gynecol. Obstet. 2022, 10(4), 203-210. doi: 10.11648/j.jgo.20221004.17

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    AMA Style

    Gamal Hassan Eltabbakh, Samantha Gregoire, Georgia Danine Eltabbakh. Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure. J Gynecol Obstet. 2022;10(4):203-210. doi: 10.11648/j.jgo.20221004.17

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  • @article{10.11648/j.jgo.20221004.17,
      author = {Gamal Hassan Eltabbakh and Samantha Gregoire and Georgia Danine Eltabbakh},
      title = {Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {10},
      number = {4},
      pages = {203-210},
      doi = {10.11648/j.jgo.20221004.17},
      url = {https://doi.org/10.11648/j.jgo.20221004.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20221004.17},
      abstract = {Objective: To compare the outcome of patients with uteri > 250 gm who had minimally invasive hysterectomy (MIH) to those who had abdominal hysterectomy (AH) using the LigaSure, stratify complications based on the uterine weight and report follow-up of patients who had vaginal morcellation. Study Design: A retrospective cohort study comparing patients with uteri > 250 gms who underwent vaginal hysterectomy (VH), laparoscopically assisted vaginal hysterectomy (LAVH) and robotic total laparoscopic hysterectomy (RTLH) to those who underwent AH. In both groups the LigaSure was used. Patients who had vaginal morcellation were followed-up. Results: A total of 166 patients were included: 10 patients had VH, 81 patients had LAVH, 22 patients had RTLH, and 53 patients had AH. Six (5%) MIH were converted to AH. Sixty-four percent of patients who needed hysterectomy were able to have successful MIH. Both groups were similar regarding age, American Society of Anesthesiologists score, previous laparotomy, previous C sections, body mass index, estimated blood loss, operative and postoperative complications, and final pathology report. The conversion and complication rates increased with uterine weight > 1000 gm. Patients who had AH had larger uteri and stayed in the hospital longer than those who had MIH. Thirty patients had vaginal morcellation with no consequences. Conclusion: Most patients with a large uterus could have save MIH with shorter hospital stay. Conversion and complications increase for uteri larger than 1000 gm. Vaginal morcellation had no consequences and the use of LigaSure provided adequate hemostasis.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Minimally Invasive Hysterectomy for the Large Uterus Using the LigaSure
    AU  - Gamal Hassan Eltabbakh
    AU  - Samantha Gregoire
    AU  - Georgia Danine Eltabbakh
    Y1  - 2022/08/10
    PY  - 2022
    N1  - https://doi.org/10.11648/j.jgo.20221004.17
    DO  - 10.11648/j.jgo.20221004.17
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
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    EP  - 210
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20221004.17
    AB  - Objective: To compare the outcome of patients with uteri > 250 gm who had minimally invasive hysterectomy (MIH) to those who had abdominal hysterectomy (AH) using the LigaSure, stratify complications based on the uterine weight and report follow-up of patients who had vaginal morcellation. Study Design: A retrospective cohort study comparing patients with uteri > 250 gms who underwent vaginal hysterectomy (VH), laparoscopically assisted vaginal hysterectomy (LAVH) and robotic total laparoscopic hysterectomy (RTLH) to those who underwent AH. In both groups the LigaSure was used. Patients who had vaginal morcellation were followed-up. Results: A total of 166 patients were included: 10 patients had VH, 81 patients had LAVH, 22 patients had RTLH, and 53 patients had AH. Six (5%) MIH were converted to AH. Sixty-four percent of patients who needed hysterectomy were able to have successful MIH. Both groups were similar regarding age, American Society of Anesthesiologists score, previous laparotomy, previous C sections, body mass index, estimated blood loss, operative and postoperative complications, and final pathology report. The conversion and complication rates increased with uterine weight > 1000 gm. Patients who had AH had larger uteri and stayed in the hospital longer than those who had MIH. Thirty patients had vaginal morcellation with no consequences. Conclusion: Most patients with a large uterus could have save MIH with shorter hospital stay. Conversion and complications increase for uteri larger than 1000 gm. Vaginal morcellation had no consequences and the use of LigaSure provided adequate hemostasis.
    VL  - 10
    IS  - 4
    ER  - 

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Author Information
  • Lake Champlain Gynecologic Oncology, Professional Corporation, South Burlington, the United States

  • Lake Champlain Gynecologic Oncology, Professional Corporation, South Burlington, the United States

  • Lake Champlain Gynecologic Oncology, Professional Corporation, South Burlington, the United States

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