Hand-Assisted Total Laparoscopic Hysterectomy of a 5200-Gram Uterus

Xiaoming Guan, MD, PhD, Anze Urh, MD, Teresa M. Walsh, MD, Vicki Ng, MD

Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX, USA (Drs. Guan, Walsh). Department of Obstetrics & Gynecology, Brown University, Providence, RI, USA (Dr. Urh). Department of Obstetrics & Gynecology, St. Luke’s Women’s Center, San Francisco, CA, USA (Dr. Ng).


Introduction: Hysterectomy is one of the most common gynecologic procedures performed. Minimally invasive laparoscopic techniques are preferred; however, laparotomy is still commonly performed for large uteri.

Case Description: We performed hand-assisted total laparoscopic hysterectomy of a 5200-g uterus.

Discussion: Hand-assisted laparoscopy is an alternative approach to laparotomy for large uteri and has similar benefits to traditional laparoscopic surgery. To our knowledge, the uterus in our patient is the largest uterus reported to have been removed laparoscopically.

Key Words: Large uterus, Fibroids, Hysterectomy, Laparoscopic hysterectomy, Hand assist.

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