Study Objective:This study aimed to investigate the morbidity of laparoscopic myomectomy (LM) versus open myomectomy (OM), including intraoperative blood loss, duration of surgery, hospital stay, and complications and to evaluate the criteria for selection of cases suitable for LM.Design:This was a retrospective study.Setting:This study was conducted at tertiary hospital.Participants:The records of 67 women who underwent LM, 22 women who underwent OM, and 14 women who had laparo-conversion from January 2010 to November 2014 were reviewed.Measurement and Main Results:Fibroids up to 10 cm were removed by LM, while most fibroids more than 10 cm were managed through OM. The number and weight of myomas are significantly associated with laparo-conversion, with a rate of 17%. Mean blood loss was significantly reduced in LM group than the OM and laparo-conversion groups. Duration of hospital stay was also significantly less in LM (2 ± 1 days) compared to both OM and laparo-conversion groups (3 ± 1 days). Most women underwent LM (88%) had no postoperative complications compared to OM (50%) and laparo-conversion (57.1%). The number of fibroids removed and duration of surgery was positively correlated with blood loss in the women who underwent myomectomy.Conclusion:LM is an ideal surgical approach for removal of fibroids which are up to 10 cm diameter and <5 in number, while OM is useful for cases with multiple (5 or more), larger fibroids (>10 cm), and deeply located fibroids. Preoperative evaluation of the size and number of myomas is necessary to avoid laparo-conversion and to reduce intraoperative and postoperative complications.

Cornual pregnancy happens when implantation occurs in the cavity of a rudimentary horn of the uterus, which may or may not be communicating with the uterine cavity. The diagnosis of cornual pregnancy remains challenging, and rupture of a cornual pregnancy usually causes massive bleeding. Early diagnosis and treatment, therefore, are very crucial and key to prevent mortality. Historically, the management of cornual pregnancies included wedge resection through open surgery or even hysterectomy. In this case report, we would like to highlight a case of late second trimester cornual pregnancy, at 19-week and 3-day gestation, which was managed laparoscopically.

Objective: The study objective was to determine the feasibility and selection criteria for discharge within 24 h posttotal laparoscopic hysterectomy with or without bilateral salpingo-oophorectomy (TLH with or without BSO) in Hospital Putrajaya. Materials and Methods: A total of thirty patients among all gynecology inpatients who were planned for TLH with or without BSO with controlled medical diseases, normal preoperative investigations, and uncomplicated surgery were recruited from January 2014 to December 2016. Data were collected from electronic medical records. Postoperatively, patients who fulfilled the selection criteria were discharged within 24 h and were followed up at 6 weeks and 3 months postsurgery. The results were presented as frequency with percentage and mean standard deviation. Results: All patients who had uncomplicated surgery and blood loss <1 l with no early postoperative complications were discharged within 24 h. They had a pain score of < 3 and were able to ambulate and tolerated orally well. None of these patients who were discharged 24 h postsurgery required readmissions. During follow-up, there were no reported complications such as persistent pain, wound infection, or herniation. Conclusion: Twenty-four hours' discharge post-TLH with or without BSO is feasible and safe if the selection process is adhered to.