Laparoscopic Myomectomy

Dubuisson, Jean‐Bernard; Chapron, Charles

doi:10.1007/978-1-4471-0655-5_7

Cited by 4 publications

(4 citation statements)

References 49 publications

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“…With the development of minimal access therapy, we have witnessed successful techniques to remove submucous myomas by hysteroscopic surgery (Hart 2006) and intramural and subserous myomas by laparoscopic myomectomy (Dubuisson et al 1998). Because of the difficulty of laparoscopic myomectomy and the need to suture the uterine wall carefully to withstand contractions of a subsequent pregnancy to avoid uterine rupture, others have searched for alternative methods to destroy the tumours, including laparoscopic myolysis with a bipolar needle, developed by Adolph Gallinat in Hamburg, and by the Nd:YAG laser (Gallinat 1993).…”

Section: Minimal Access Therapymentioning

confidence: 99%

The History and Epidemiology of Fibroids

Sutton

2012

Radiological Interventions in Obstetrics and Gynaecology

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Section: Minimal Access Therapymentioning

confidence: 99%

The History and Epidemiology of Fibroids

Sutton

2012

Radiological Interventions in Obstetrics and Gynaecology

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“…4,5 Laparoscopic removal of fibroids has been shown to be possible since the early 1990s but has not been widely adopted, especially for large fibroids, presumably due to limitations in surgical expertize and training required. 6,7 Laparoscopic myomectomy has the great advantages of short hospital stay, reduced analgesic requirement, rapid recovery to normal activity, reduced risk of adhesions, and almost immediate symptomatic benefit. Laparoscopic myomectomy is restricted by the size and the location of the fibroids.…”

Section: 5005/jp-journals-10033-1193mentioning

confidence: 99%

Laparoscopic Myomectomy for Large Fibroids with Synchronized use of Uterine Artery Embolization

Kamran¹,

Madhuri²,

Walker³

et al. 2013

WJOLS

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Objective: To determine the feasibility and efficacy of the laparoscopic myomectomy for large fibroids (>10 cm) with use of synchronous uterine artery embolization.Design: A prospective observational case series of laparoscopic myomectomy performed for single and multiple uterine fibroids.Setting: A tertiary referral center for gynecological oncology and minimal access surgery. Materials and methods:Laparoscopic myomectomy was performed using harmonic scalpel with synchronized preoperative uterine artery embolization (UAE) following multidisciplinary team discussion. Tissue retrieval was performed by morcellation. Main outcome measures:Early discharge and reduced intraoperative blood loss.Results: Of all 15 cases, mean number of fibroids removed was 2 (range: 1-4) and mean mass of tissue excised was 450 gm (range: 320-1540). The mean diameter of the fibroids removed was 13 cm (range: 10-20 cm). Mean estimated blood loss was 156 ml (range: 25-1,000 ml) and the mean operating time was 113 minutes (17-200 minutes). All cases were successfully completed laparoscopically with no conversions to open surgery. One patient who had a 13 cm broad ligament fibroid required a 2 unit blood transfusion intraoperatively and another patient developed a single port-site infection 2 weeks following the procedure. Histology confirmed benign leiomyomas in all cases. Conclusion:Laparoscopic myomectomy with use of synchronized UAE using harmonic scalpel is feasible and efficient procedure for single or multiple large fibroids within an experienced multidisciplinary setting.

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“…Reproductive outcomes after laparoscopic myomectomy are similar to those after laparotomy. 17 In patients without any factors for infertility other than myomas, the percentage of intrauterine pregnancies following laparoscopic myomectomy is 55%. 18 The main issue surrounding reproductive outcome and laparoscopic myomectomy has been the potential for uterine rupture.…”

Section: Fertilitymentioning

confidence: 99%

Endoscopic Management of Leiomyomata

Advincula

Song²

2004

Semin Reprod Med

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Prior to the advent of modern minimally invasive surgery techniques, the primary surgical management of symptomatic leiomyomata for women desiring future fertility or uterine conservation was through laparotomy. Today, many cases of intramural and subserous leiomyomata are managed with laparoscopic myomectomy and selected cases of submucosal leiomyomata are managed with hysteroscopic myomectomy. The management of leiomyomata endoscopically is one of the more challenging procedures in minimally invasive surgery and requires a skilled surgeon. Despite its benefits, such as faster postoperative recovery and potentially less postoperative adhesions compared with laparotomy, many concerns still exist. Although pregnancy rates for women with leiomyomata managed endoscopically are similar to those after laparotomy, a major worry continues to be the risk of uterine rupture. The risk is essentially unknown. Lastly, the risk of recurrence seems higher after laparoscopic myomectomy compared with laparotomy.

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Laparoscopic Myomectomy

Cited by 4 publications

References 49 publications

The History and Epidemiology of Fibroids

The History and Epidemiology of Fibroids

Laparoscopic Myomectomy for Large Fibroids with Synchronized use of Uterine Artery Embolization

Endoscopic Management of Leiomyomata

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