A simplified method to decrease operative blood loss in laparoscopic-assisted vaginal hysterectomy for the large uterus

Study Objective. To evaluate the role of oxytocin in decreasing operative blood loss in laparoscopic-assisted vaginal hysterectomy (LAVH) for the large uterus (weight ≥500 g). Design. Prospective clinical study (Canadian Task Force classification 11-2). Setting. Tertiary care university hospital. Patients. Eighty-eight women scheduled for a hysterectomy for large benign uterine tumors. Intervention. Two ampules of oxytocin (10 u/mL/amp) were added to 1000 mL of saline solution running at the rate of 40 mU/min during the course of LAVH. Measurements and Main Results. Blood loss and blood transfusion rate were significantly greater in the group without oxytocin infusion (group B) than in the group with oxytocin infusion (group A), with 485.7 ± 321.6 mL versus 364.1 ± 173.2 mL (p <.05) and 26.7% versus 6.1% (p <.05), respectively. There was no significant difference in average age, body weight, and number of vaginal deliveries and cesarean sections between the two groups. There also was no significant difference in mean uterine weight, postoperative stay, and complications between the two groups. Conclusion. Oxytocin infusion can cause uterine contractions that decrease uterine perfusion. It is a safe and inexpensive method to help decrease operative blood loss during LAVH for the large uterus.