Operating time and blood loss during laparoscopic‐assisted vaginal hysterectomy with in situ morcellation

Abstract

To develop a regression-based prediction equation for operative time and estimated blood loss in laparoscopically assisted vaginal hysterectomy (LAVH) for large uteri, as required, by combined laparoscopic in situ and vaginal morcellation. Prospective study (Canadian Task Force classification II-1). University-affiliated hospitals. Fifty-six patients who underwent LAVH. Methods. Evaluation of all patients who had LAVH with laparoscopic in situ morcellation and vaginal morcellation during a 2-year period. Operative time, estimated blood loss, total uterine weight by laparoscopic or vaginal morcellation, complications and length of hospital stay. Mean operative time was 133 ± 22 minutes, and mean blood loss 133 ± 101 ml. Mean uterine weight was 383 ± 187 g by laparoscopic and 251 ± 103 g by vaginal morcellation. Greater total uterine weight and morcellation were associated with longer operative times. Blood loss correlated with uterine weight when vaginal morcellation was also used. A regression equation is presented for estimating the likely operating time and blood loss. An increase in the operative time and a higher blood loss can be expected as the uterine weight increases and can be predicted taking morcellation methods into account.