Objective

To evaluate the potential effect of uterine weight on short-term outcome and incidence of complications after total laparoscopic hysterectomy (TLH) for a benign gynecologic disease. Methods A retrospective medical record review of 771 cases where TLH was performed. Patients included in this study underwent TLH for either myoma or adenomyosis at Gil Hospital, Gachon University of Medicine and Science, from March 2006 through December 2010. Participating patients were stratifi ed into three groups: group 1 with uterine weight less than 250 g (n = 435), group 2 with uterine weight 250 to 500 g (n = 272), and group 3 with uterine weight more than 500 g (n = 64). The groups were compared based on total operation time, estimated blood loss, length of postoperative hospital stay, observations of postoperative complications, and rate of conversion from to TLH to laparotomy. Results We discovered no statistical difference between the three groups in terms of overall postoperative complications or short-term surgical outcomes. Major complications such as ureter injury and necessity for reoperation occurred in each group. Operation time and estimated blood loss increased slightly as uterine weight increased, but, there was no statistical signifi cance. Conclusion TLH can be successfully performed, even in cases of enlarged uterus. Patients with an enlarged uterus are suitable candidates for TLH.