Morbidity was low. Age had no impact. Laparoscopic myomectomy can be offered to all women.

To describe and to analyse the learning effect in laparoscopic myomectomy. Hospital chart records of 351 patients were retrospectively evaluated. Myomectomy was performed in a standardised fashion. To assess a potential learning effect, only cases presenting a singular intramural fibroid were analysed if a surgeon had done more than ten laparoscopic myomectomies of this type. Cases were analysed according to the order of surgery for the individual surgeon: group A comprised the first ten cases of each surgeon compared with group B, which comprised the subsequent cases. Eighty cases were performed by five surgeons. Group A comprised 50 cases and group B comprised 30 cases. No difference was found with regard to patients' age, BMI, and size of the fibroid. Rate of intraand postoperative complications according definition were lower in group B but failed to be of statistical significance. Duration of surgery improved after ten cases and no severe complications were noted beyond the tenth case. A learning experience of at least ten laparoscopic myomectomies was necessary in our institution to improve duration of surgery and to reach a low level of severe complications.Duration of the surgical procedure and rate of severe complication were adequate study end points to assess a learning effect.

The high overall level of satisfaction and positive outcome in various age groups contradicts current recommendations against laparoscopic myomectomy for women over 40 years of age.