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Case Reports in Medicine
Volume 2017, Article ID 1637472, 5 pages
Case Report

Factors for a Successful Laparoscopic Hysterectomy in Very Large Uteri

1Clinic of Obstetrics and Gynecology, St. Anna Hospital, Herne, Nordrhein-Westfalen, Germany
2Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Niedersachsen, Germany

Correspondence should be addressed to Harald Krentel; gro.apgec@letnerk

Received 3 April 2017; Revised 9 July 2017; Accepted 2 August 2017; Published 6 September 2017

Academic Editor: Robert A. Kozol

Copyright © 2017 Harald Krentel and Rudy Leon De Wilde. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Minimally invasive hysterectomy is a standard procedure. Different approaches, as laparoscopically assisted vaginal hysterectomy, vaginal hysterectomy, and subtotal and total laparoscopic hysterectomy, have been described and evaluated by various investigations as safe and cost-effective methods. In particular, in comparison to abdominal hysterectomy, the minimally invasive methods have undoubted advantages for the patients. The main reason for a primary abdominal hysterectomy or conversion to abdominal hysterectomy during a minimal invasive approach is the uterine size. We describe our course of action in the retrospective analysis of five cases of total minimal-access hysterectomy, combining the laparoscopic subtotal hysterectomy and the vaginal extirpation of the cervix in uterine myomatosis with a uterine weight of more than 1000 grams, and discuss the factors that limit the use of laparoscopy in the treatment of big uteri. Trail Registration. The case report is registered in Research Registry under the UIN researchregistry743.