RESUMO
OBJECTIVE: To determine the feasibility and safety of performing laparoscopically assisted vaginal hysterectomy (LAVH) for uteri weighing 500 g or more and evaluate the advantages and complications of LAVH. METHODS: A subpopulation of 30 women with uteri weighing 500 g or more from group of 412 patients undergoing LAVH between Mar, 2003 to Feb, 2005. We reviewed medical records and analyzed these cases about age, parity, history of previous abdominal surgery, preoperative indications, postoperative pathologic diagnosis, mean operation times, weight of extracted uterus, change of hemoglobin, hospital stay, and complications. RESULTS: The mean age was 44.8+/-3.88 years. The mean parity was 1.78+/-0.76. Previous operation history was 16 cases (53.3%). The most common indication of operation was palpable abdominal mass. The most common pathologic diagnosis was leiomyoma. The mean operation time was 126.40+/-39.30 minutes. The mean weight of uterus was 621.23+/-107.28 g. The mean hemoglobin change was 1.57+/-1.14 g/dL. The mean hospital stay was 3.74+/-0.88 days. The only complication of operation was superficial trocar site bleeding (1 case). CONCLUSION: LAVH is a safe and effective alternative to total abdominal hysterectomy of the uteri weighing 500 g or more in selective groups.