Large sized uteruses normally have multiple fibroids or one huge fibroids
Yes, laparoscopic hysterectomy or removal of uterus is possible even if the uterus size is more than 12 to 14 weeks or even if has fibroid more than 6cm.
Currently laparascopic hysterectomy is considered as a safe and efficient method of hysterectomy.
Laparascopic hysterectomy is clearly associated with decreased blood loss, shorter hospital stay, faster return to normal activities and less chance of postoperative wound infection.
In laparascopy the incisions are small few millimeters in size numbering 3 to 4 compared to a 10cm or more incision size in open hysterectomy.
Following are concerns if the uterus is big…..
1.How do we remove it through a small incision?
An instrument called morcellator is used which cuts the uterus into strips which are removed through the small incision.
2.Does the complication rate increase?
As with any surgical procedure laparoscopic hysterectomy has incidence of complications ranging 0.1 to 10% such as injury to intestines, bladder, ureter or to blood vessels.By adequate preoperative bowel preparation and right surgical techniques aswell as training, the complication rate can be kept at the minimum even with large sized uterus.