Effectiveness of laparoscopic ultrasonography in laparoscopic myomectomy

Abstract

Introduction Laparoscopic myomectomy (LM) has become increasingly common in recent years because it minimizes invasiveness. However, myoma can recur after myomectomy. Therefore, we began using laparoscopic ultrasonography, which involves inserting a probe into the peritoneal cavity via a trocar and placing it in direct contact with the uterus. During surgery, this enables the detection of myomas as a small as 1 mm in diameter, which are often undetectable on MRI. Here, we report the effectiveness of laparoscopic ultrasonography. Methods The subjects were 26 women who underwent LM at our institution from February 2015 to December 2016. Preoperative MRI was performed, and all myomas detected on MRI were removed during LM. Laparoscopic ultrasonography was then performed to assess for residual myomas, which were removed. Results In six patients (23%), residual myomas were identified on laparoscopic ultrasonography after the first enucleation of the myomas detected on preoperative MRI. All detected residual myomas, the largest of which was less than 10 mm in diameter, were removed. Conclusion Small myomas undetectable on preoperative MRI were detected on laparoscopic ultrasonography and removed.

Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy

“…Several authors use intraoperative transvaginal ultrasound to overcome this limitation. However, the transvaginal ultrasound probe requires the use of sterile probe-covers and is time-consuming, expensive, and not always available (Shigeta et al, 2020). Moreover, ultrasound has limited effectiveness for detecting myomas smaller than 5 mm in diameter (Shigeta et al, 2020).…”