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Objective: To assess the factors influencing operative time and intraoperative blood loss in patients who had undergone laparoscopic myomectomy (LM). Methods: The study involved 374 patients who had undergone LM at our hospital between May 2009 and April 2011. We examined the relationships between operative time, intraoperative blood loss, maximum myoma diameter, number of resected myomas, and myoma growth patterns (5 groups: intramural, submucosal, subserosal, pedunculated subserosal, and intraligamentous). Results: There was a correlation between maximum myoma diameter, operative time (y = 0.73x + 51.51; r = 0.393), and intraoperative blood loss (y = 3.76x − 121.12; r = 0.456). Furthermore, the number of resected myomas was correlated with operative time (y = 5.06x + 81.71; r = 0.308) and intraoperative blood loss (y = 3.49x + 99.55; r = 0.049). There was a significant difference in operative time between pedunculated subserosal myomas and intraligamentous myomas, but there was no significant difference in intraoperative blood loss between myomas displaying different growth patterns. Conclusions: The maximum myoma diameter was a factor influencing operative time and intraoperative blood loss. In addition, the results suggested that operative time was influenced by the number of resected myomas and the growth patterns of myomas.

Uterine myomectomy is a procedure that is relatively prone to postoperative adhesion formation, which can cause infertility, chronic pelvic pain, and bowel obstruction. The sheet adhesion barriers, Interseed and Seprafilm, have been widely used to reduce such postoperative adhesions and have been effective to some extent. However, due to the characteristics of these sheet-based materials, a certain level of experience and skill is required to insert the barrier in the abdominal cavity and place it in the appropriate site. In contrast, Adspray is a spray-type barrier that is relatively easier to use than sheet-based barriers and has been reported to shorten the operation time. We have experienced 11 cases in which we were able to evaluate the anti-adhesion effects of Adspray after myomectomy. This study supports the effectiveness of Adspray to prevent adhesion.