Design: Video presentation. Patient consent was obtained.

Setting: A tertiary referral center and teaching hospital.

Patients or Participants: A 46 years old female with complaining of AUB-L and bulk symptoms. She has no PMH or PSH. BMI was 45 and uterus was about 35 weeks size on examination.

Interventions: Thorough preoperative counseling was conducted and the patient desired minimally invasive surgical intervention. The patient understood the minimal possibility of occult uterine sarcoma and agreed to specimen extraction without containment. The patient understood that power morcellation is not allowed in our practice. Laparoscopic hysterectomy was performed.

Measurements and Main Results: The total operative time was about 5 hours. The EBL was 50 cc and the specimen weighted 3064 grams. The patient was discharged at POD#1.

Conclusion: Laparoscopic hysterectomy on extreme large uterus is feasible, safe and beneficial to patients.