Laparoscopic hysterectomy is one of the most common treatment for uterine fibroids. According to resection range, hysterectomy can be total or supracervical. Almost all the laparoscopic hysterectomy due to fibroids can be performed by laparoscopy, but hysterectomy of a large uterus requires power morcellation to facilitate removal, which links to an increased risk of disseminating occult malignancy into the abdominal and peritoneal cavities, and it has become a main reason for restriction of laparoscopic hysterectomy. The crucial part of laparoscopic hysterectomy is good exposure and proper processing of the vessels, the bladder and ureters. To achieve better exposure and operating space, the use of a uterine manipulator and placement of Trocars are important.
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McPherson K, Metcalfe MA, Herbert A, et al. Severe complications of hysterectomy: the VALUE study. BJOG. 2004;111(7):688–94.CrossRefPubMedGoogle Scholar
O’Hanlan KA, McCutcheon SP, McCutcheon JG. Laparoscopic hysterectomy: impact of uterine size. J Minim Invasive Gynecol. 2011;18(1):85–91.CrossRefPubMedGoogle Scholar
Demir RH, Marchand GJ. Safe laparoscopic removal of a 3200 gram fibroid uterus. JSLS (Journal of the Society of Laparoendoscopic Surgeons/Society of Laparoendoscopic Surgeons). 2010;14(4):600–2.CrossRefGoogle Scholar
Walid MS, Heaton RL. Total laparoscopic hysterectomy for uteri over one kilogram. JSLS (Journal of the Society of Laparoendoscopic Surgeons/Society of Laparoendoscopic Surgeons). 2010;14(2):178–82.CrossRefGoogle Scholar
Zeng W, Chen L, Du W, Hu J, Fang X, Zhao X. Laparoscopic hysterectomy of large uteri using three-trocar technique. Int J Clin Exp Med. 2015;8(4):6319–26.PubMedPubMedCentralGoogle Scholar
AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL practice report: Morcellation during uterine tissue extraction. J Minim Invasive Gynecol. 2014;21(4):517–30.CrossRefGoogle Scholar
Brown J. AAGL advancing minimally invasive gynecology worldwide: statement to the FDA on power morcellation. J Minim Invasive Gynecol. 2014;21(6):970–1.CrossRefPubMedGoogle Scholar
Senapati S, Tu FF, Magrina JF. Power morcellators: a review of current practice and assessment of risk. Am J Obstet Gynecol. 2015;212(1):18–23.CrossRefPubMedGoogle Scholar