Laparoscopic Hysterectomy techniques keeps changing, specially with different methods of tackling uterine arteries. 2483 Laparoscopic Hysterectomy done from February 1994 till July 2014 were evaluated for uterine artery hemostasis.

Uterine arteries were tackled at origin from internal iliac artery in 156 cases. Of these, 28 patients were obese BMI (> 30).

A comparative evaluation of tackling uterine artery at the origin from internal iliac artery in obese patients and normal patients was done. We evaluated Ease of trocar placements, lengths of trocar used, visualization of anatomy, and technical ease in carrying out internal iliac artery ligation, bleeding, possibility in difficult pathology & specially ureteric or vesical injury.

Technical difficulties in trocar placement was as anticipated in the obese patients and longer trocars were used for the obese patients. Once instruments were in place further surgical technique was similar in both groups.

We conclude that in obese patients, laparoscopy is a better technique to operate rather than open surgery. Special care has to be taken in instrumentation for obese patients. Once intstruments are in place technically obese patients are similar to the non-obese groups for laparoscopy surgeries. Same holds true for uterine artery ligation with no significant differences being found in various surgical and technical parameters compared.