Hand-assisted laparoscopic hysterectomy for large uteri

Teresa M. Walsh, Haleh Sangi-Haghpeykar, Vicky Ng, Robert Zurawin, Xiaoming Guan

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Study objective: To determine whether laparoscopic hand-assisted hysterectomy for a large uterus had different surgical outcomes compared with traditional open hysterectomy. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Academic tertiary care hospital. Patients: Women who had undergone laparoscopic hand-assisted hysterectomy for a large uterus were included as the hand-assist group. The control group comprised patients with similar final specimen weight (>1 kg), characteristics (body mass index, age), and surgical history, who underwent open hysterectomy for a large uterus. Intervention: Laparoscopic hysterectomy using a hand-assist port for laparoscopic portion of the case. Results: The 2 groups were similar in terms of specimen weight (median, 1765.5 g for hand-assist vs 1215.50 g for controls; p = .29). In univariate analysis, the median operating time was longer in the hand-assist group compared with controls (241.5 minutes vs 185.0 minutes; p = .002), whereas median length of stay was shorter in the hand-assist group (1.0 day vs 3.0 days; p < .0001). These differences remained significant after adjustment for potential confounders in multivariable analysis (p < .05). There was no difference in estimated blood loss (p > .05) between the 2 groups, although the change in hemoglobin was less in the hand-assist group compared with controls in multivariable analysis (adjusted mean.74 vs. 1.8; p = .04). Complications were divided into intraoperative complications (transfusion, consultation, bowel injury, bladder injury, ureter injury, and other), hospital postoperative complications (reoperation, transfusion, slow return of bowel function, ileus, poor pain control, fever of unknown origin, venous thromboembolism, pneumonia, and neuropathy), and complications after discharge (readmission, wound infection). The 2 groups had a similar low rate of complications (p > .05). Conclusion: Laparoscopic hand-assist hysterectomy is a feasible alternative to open hysterectomy in patients with a large uterus.

Original languageEnglish (US)
Pages (from-to)1231-1236
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume22
Issue number7
DOIs
StatePublished - Jan 1 2015

Fingerprint

Hysterectomy
Uterus
Hand
Wounds and Injuries
Fever of Unknown Origin
Weights and Measures
Ileus
Venous Thromboembolism
Intraoperative Complications
Advisory Committees
Wound Infection
Tertiary Healthcare
Ureter
Reoperation
Tertiary Care Centers
Length of Stay
Pneumonia
Hemoglobins
Urinary Bladder
Body Mass Index

Keywords

  • Fibroids
  • Hand-assist
  • Hand-assisted hysterectomy
  • Laparoscopic hysterectomy
  • Large uterus
  • Total laparoscopic hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Walsh, T. M., Sangi-Haghpeykar, H., Ng, V., Zurawin, R., & Guan, X. (2015). Hand-assisted laparoscopic hysterectomy for large uteri. Journal of Minimally Invasive Gynecology, 22(7), 1231-1236. https://doi.org/10.1016/j.jmig.2015.06.022

Hand-assisted laparoscopic hysterectomy for large uteri. / Walsh, Teresa M.; Sangi-Haghpeykar, Haleh; Ng, Vicky; Zurawin, Robert; Guan, Xiaoming.

In: Journal of Minimally Invasive Gynecology, Vol. 22, No. 7, 01.01.2015, p. 1231-1236.

Research output: Contribution to journalArticle

Walsh, TM, Sangi-Haghpeykar, H, Ng, V, Zurawin, R & Guan, X 2015, 'Hand-assisted laparoscopic hysterectomy for large uteri', Journal of Minimally Invasive Gynecology, vol. 22, no. 7, pp. 1231-1236. https://doi.org/10.1016/j.jmig.2015.06.022
Walsh, Teresa M. ; Sangi-Haghpeykar, Haleh ; Ng, Vicky ; Zurawin, Robert ; Guan, Xiaoming. / Hand-assisted laparoscopic hysterectomy for large uteri. In: Journal of Minimally Invasive Gynecology. 2015 ; Vol. 22, No. 7. pp. 1231-1236.
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