Feasibility, Safety, and Prediction of Complications for Minimally Invasive Myomectomy in Women With Large and Numerous Myomata

Vargas, Maria V.; Moawad, Gaby; Sievers, Cem; Opoku‐Anane, Jessica; Marfori, Cherie Q.; Tyan, Paul; Robinson, James K.

doi:10.1016/j.jmig.2016.11.014

Cited by 35 publications

(28 citation statements)

References 18 publications

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“…The authors concluded that MIS for large, numerous myomas is feasible, and that the complications were not different from those of MIS for smaller, fewer myomas. 25 In our study also showed that 126 RALM for large (sized over 10 cm) or heavy (weighing over 250 g) myomas is feasible, and 28 cases were RALM in cases with five or more myomas. There were two cases of 10 myomas and three cases each of 15 myomas, 30 myomas, 34 myomas; therefore, numerous myomas are not necessarily a contraindication of RALM.…”

Section: Discussionsupporting

confidence: 66%

“…24 In terms of MIS for large myomas, a recent study published in 2017 analyzed the cases of three high-volume centers and reported the complications of MIS (n=221, 100 cases of RALM and 116 cases of LM) and AM (n=29) for large, numerous myomas performed over 44 months. 25 The authors compared the cases (with complications) and the controls (without complications), and also compared the results with previously published data on MIS myomectomy. The authors concluded that MIS for large, numerous myomas is feasible, and that the complications were not different from those of MIS for smaller, fewer myomas.…”

Section: Discussionmentioning

confidence: 99%

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Robot-Assisted Laparoscopic Myomectomy versus Abdominal Myomectomy for Large Myomas Sized over 10 cm or Weighing 250 g

Lee

et al. 2020

Yonsei Med J

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ic myomas who are unresponsive to medical treatment, myomas compressing the adjacent organs, or myomas associated with subfertility are candidates for hysterectomy or myomectomy. Myomectomy is the fertility-preserving surgical option. However, the original myomectomy surgical technique, abdominal myomectomy (AM), is associated with larger abdominal incision, more postoperative pain, more analgesic use, longer hospital stay, and higher risk of postoperative pelvic adhesion compared to minimally invasive surgery (MIS). 3-5 Therefore, MIS techniques, such as laparoscopic myomectomy (LM) and robot-assisted laparoscopic myomectomy (RALM), have been replacing AM in a broader number and variety of cases. In many countries, including Korea, there has been a trend toward the increased use of RALM. 5-7 The use of RALM has several advantages. First, it uses the Endowrist technology, which allows the articulation of instruments

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Laparoscopic Myomectomy versus Abdominal Myomectomy for Large Myomas Sized over 10 cm or Weighing 250 g

Lee

et al. 2020

Yonsei Med J

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“…One possible, albeit worrying, explanation for this may be that these residents do not realize that these complex cases can be safely completed Values reported as n (%). Not all variables represented; not all cumulative n = 159 P < 0.05 bold laparoscopically [22,23]. Currently, no required case minimums exist for laparoscopic excision of endometriosis or laparoscopic myomectomy [10].…”

Section: Discussionmentioning

confidence: 99%

Ob/Gyn resident self-perceived preparedness for minimally invasive surgery

et al. 2020

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Background: Very little is known regarding the readiness of senior U.S. Ob/Gyn residents to perform minimally invasive surgery. This study aims to evaluate the self-perceived readiness of senior Ob/Gyn residents to perform complex minimally invasive gynecologic surgery as well as their perceptions of the minimally invasive gynecologic surgery subspecialty. Methods: We performed a national survey study of 3rd and 4th year Ob/Gyn residents. A novel 58-item survey was developed and sent to residency program directors and coordinators with the request to forward the survey link along to their senior residents. Results: We received 158 survey responses with 84 (53.2%) responses coming from 4th year residents and 74 (46.8%) responses from 3rd year residents. Residents who train with graduates of a fellowship in minimally invasive gynecologic surgery felt significantly more prepared to perform minimally invasive surgery compared to residents without this exposure in their training. The majority of senior residents (71.5%) feel their residency training adequately prepared them to be a competent minimally invasive gynecologic surgeon. However, only 50% feel prepared to perform a laparoscopic hysterectomy on a uterus greater than 12 weeks size, 29% feel prepared to offer a vaginal hysterectomy on a uterus 12-week size or greater, 17% feel comfortable performing a laparoscopic myomectomy, and 12% feel prepared to offer a laparoscopic hysterectomy for a uterus above the umbilicus. Conclusions: The majority of senior U.S. Ob/Gyn residents feel prepared to provide minimally invasive surgery for complex gynecologic cases. However, surgical confidence in specific procedures decreases when surgical complexity increases.

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“…The most popular proposed alternative is in-bag morcellation. Vargas et al compared outcomes of women who underwent open versus contained morcellation and the only difference was an increase in operating time (69). Some argue that myometrial spillage occurs during the process of myomectomy and that spillage of myometrial cells has been noted even after open myomectomy (70).…”

Section: Alternatives To Power Morcellationmentioning

confidence: 99%

Rethinking the Issue of Power Morcellation of Uterine Fibroids: Is Morcellation the Real Problem or Is this Another Symptom of Disparity in Healthcare Provision?

Odejinmi

Aref‐Adib

Liou

et al. 2019

In Vivo

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Feasibility, Safety, and Prediction of Complications for Minimally Invasive Myomectomy in Women With Large and Numerous Myomata

Cited by 35 publications

References 18 publications

Robot-Assisted Laparoscopic Myomectomy versus Abdominal Myomectomy for Large Myomas Sized over 10 cm or Weighing 250 g

Robot-Assisted Laparoscopic Myomectomy versus Abdominal Myomectomy for Large Myomas Sized over 10 cm or Weighing 250 g

Ob/Gyn resident self-perceived preparedness for minimally invasive surgery

Rethinking the Issue of Power Morcellation of Uterine Fibroids: Is Morcellation the Real Problem or Is this Another Symptom of Disparity in Healthcare Provision?

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