How to manage multiple fibroids in reproductive laparoscopic surgery

Parasitic leiomyoma after laparoscopic myomectomy

“…5,6 Removal of an excised uterine myoma through a laparoscopic incision requires morcellation of the mass. 7,8 Myomatous fragments during morcellation at the time of myomectomy or hysterectomy may be left behind unintentionally. The electric morcellator produces minute fragments of myoma tissue, even with correct use and careful observation.…”

“…Case reports or series often disclose patients with pain, pelvic pressure, dyspareunia, abdominal or pelvic mass, mass at the abdominal wall, or even an incidental asymptomatic tumor, found upon regular medical checkups. 4,7,13 As these symptoms are more commonly associated with uterine myomas, the diagnosis of parasitic myomas is often incidental at the time of surgery for symptomatic uterine myomas.…”

Effect of magnetic resonance imaging characteristics on uterine fibroid treatment

“…[4][5][6][7][8] It is crucial to avoid laparoscopic myomectomies in patients who have more than five fibroids, as the procedure is excessively time-consuming. 12,20,21 Studies have demonstrated that the mean total laparoscopic operating time in patients with a single uterine fibroid is significantly shorter than that in patients with ≥2 uterine fibroids. 20,21 Furthermore, patients with ≥5 have an increased risk of technical failure of HIFU treatment (Table 1).…”

“…12,20,21 Studies have demonstrated that the mean total laparoscopic operating time in patients with a single uterine fibroid is significantly shorter than that in patients with ≥2 uterine fibroids. 20,21 Furthermore, patients with ≥5 have an increased risk of technical failure of HIFU treatment (Table 1). 17,18 Uterine leiomyomatosis is a specific condition, manifesting in innumerable small uterine fibroids, which cause a symmetrical enlargement of the uterus.…”