Relevance of Uterine Weight for Predicting Surgical Complications in Minimally Invasive Benign Hysterectomy

To describe the uterine weight threshold for increasing risk of complications after a laparoscopic hysterectomy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cross-sectional analysis using the American College of Surgeons NSQIP database from 2016 to 2021. American College of Surgeons NSQIP database. Patients undergoing minimally invasive hysterectomy for benign indications (N = 64 289). None. Uterine weight was entered in grams and 30-day complications were abstracted from patient charts. In the analytic sample, median uterine weight was 135 grams (interquartile range, 90–215) and 6% of patients (n = 4085) experienced complications. Uterine weight performed very poorly in predicting complications on bivariate analysis (area under the receiver operating characteristics curve, 0.53; 95% confidence interval, 0.53–0.54). On multivariable analysis, a uterine weight cutoff of 163 grams was associated with higher odds of complications (odds ratio, 1.11; 95% confidence interval, 1.03–1.19; p = .003), but this threshold achieved only a 43% sensitivity and 62% specificity for predicting complications. Uterine weight alone possessed negligible utility for predicting the risk of perioperative complications in minimally invasive hysterectomy.