Size can matter: Laparoscopic hysterectomy for the very large uterus

Brought to you by the Society of Gynecologic Surgeons. In this video, the author describes surgical approaches to laparoscopic hysterectomy of a very large uterus (>2.5 kg). Preoperative strategies include the use of radial artery–uterine artery embolization, magnetic resonance imaging (MRI), and a gonadotropin-releasing hormone agonist (GnRH agonist). Intraoperative techniques include use of ureteral stents, securing the uterine artery at its origin, and maximizing port placement to allow for visualization and tissue extraction.