Fig. 11.1
Port placement in large fibroids
11.2 Results
In the present series only one laparotomy was performed in a 2.2 kg uterus where heavy bleeding encountered when the laparoscopic dissection of the uterus was performed, otherwise laparoscopic approach was utilized. Both in the TLH group and the LSH group the time was 75 min, however in larger uterus and fibroids very often LSH was the preferred technique, no malignancies was seen. Power morcellation was performed in the LSH group without any problems.
11.3 Complications
In the 445 patients so far the complications rate is low 6 % compared to the 16 % in the database for hysterectomy database Denmark. The most serious we had were 2 vesicoc-vaginal fistula and one urether lesion, one bladder perforation during the surgery.
Hematoma and postoperative infection encountered in 5 % of the patient (Table 11.1).
Table 11.1
Laparoscopic hysterectomy (N = 404, year 2014)
LSH | TLH | Vag Hyst | Tot | |
|---|---|---|---|---|
N = 206, BMI=24 | N = 156, BMI=25 | N = 41, BMI=25 | N = 406 | |
Age 47 | Age 48 | Age 61 | ||
OR time | 75 (35–175) | 75 (35–150) | 85 (50–120) | 78 |
Uterine weight (g) | 394 (60–1,750) | 263 (56–1,035) | 75 (42–79) | 315 |
Bleeding (ml) | 77 (5–800) | 57 (10–300) | 63 (20–200) | 81 |
Normal activity (days) | 5 (1–14) | 6 (1–14) | 6 (1–14) | 5.5 |
Back to work (days) | 14 (1–42) | 17 (7–35) | 24 (14–49) | 16 |
Postop complication N = 100 | 4 (3 %) | 7 (6.8%) | 2 (4 %) | 12 (4.5 %) |
In 44 cases the uterine size exceeded 700 g and from Table 11.2 you can see that the operating time amount of bleeding increased significantly.
Table 11.2
Operation details in pat with weight >700 g
Or time (min) | Weight (g) | Bleeding (ml) | |
|---|---|---|---|
Mean | 108 | 1,006 | 201
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