Laparoscopic Myomectomy: An Alternative Approach to Tackling Submucous Myomas?

Oxley, Samuel; Mallick, Rebecca; Odejinmi, Funlayo

doi:10.1016/j.jmig.2019.03.015

Cited by 7 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is growing evidence that laparoscopic myomectomy can be safely considered for larger type 2 submucosal fibroids (19). On a retrospective analysis for the surgical management of type 2 submucosal fibroids ranging between 3 to 5cm (20), Wang et al did not identify significant differences regarding operation time and amount of bleeding between transcervical resection of fibroid and laparoscopic myomectomy.…”

Section: Discussionmentioning

confidence: 99%

The tip of the iceberg fibroid effect; when to avoid transcervical resection. The utilisation of 3D pelvic ultrasonography for fibroid mapping.

Lazaridis

Kogeorgos

Al-Achmar

et al. 2023

Preprint

View full text Add to dashboard Cite

Our objective is to demonstrate that moderate size type 2-4 fibroids should be removed with laparoscopic myomectomy. The use of 3D ultrasound imaging to accurately identify size and position of fibroid is essential, since it guides operative strategy especially when hysteroscopic evaluation of the submucosal fibroid component may give a false impression of its size and transcervical resection feasibility. We present a video demonstration of the diagnostic sequence and then laparoscopic myomectomy in simple steps. In conclusion, robust pre-operative assessment is necessary to avoid transcervical fibroid resections requiring prolonged operative time or multiple sessions.

show abstract

Section: Discussionmentioning

confidence: 99%

The tip of the iceberg fibroid effect; when to avoid transcervical resection. The utilisation of 3D pelvic ultrasonography for fibroid mapping.

Lazaridis

Kogeorgos

Al-Achmar

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Since its introduction in 1990s, minimally invasive surgery has gained widespread acceptance in many surgical fields due to its safety and advantages that this kind of procedure can offer as compared to open surgery [16, 17, 18, 19, 20, 21, 22, 23].…”

Section: Discussionmentioning

confidence: 99%

Barbed suture and gastrointestinal surgery. A retrospective analysis

Manigrasso¹,

Velotti²,

Calculli

et al. 2019

Open Medicine

View full text Add to dashboard Cite

AbstractAlthough minimally invasive surgery is recognized as the gold standard of many surgical procedures, laparoscopic suturing is still considered as the most difficult skill in laparoscopic surgery.The introduction of barbed sutures facilitates laparoscopic suturing because it is not necessary to tie a knot. The efficacy of this method has been evaluated in different types of surgery; however, less is known about general surgery.We retrospectively analysed data from 378 patients who had undergone bariatric or surgical treatment for colic or gastric malignancy requiring a closure of gastroentero, entero-entero or enterocolotomy from January 2014 to January 2019, admitted to the General Surgery Unit and Operative Unit of Surgical Endoscopy of the University Federico II (Naples, Italy).We registered 12 anastomotic leaks (3.1%), 16 anastomotic intraluminal bleedings (4.2%) and 7 extraluminal bleedings. Other complications included 23 cases of postoperative nausea and vomit (6%), 14 cases of postoperative ileus (3.7%) and 3 cases of intra-abdominal abscess (0.8%). Overall complications rate was 19.8% (75/378). No postoperative death was registered.Thus, by pooling together 378 patients, we can assess that barbed suture could be considered safe and effective for closure of holes used for the introduction of a branch of mechanical stapler to perform intracorporeal anastomosis.

show abstract

“…Endoscopy indicate that common surgical methods include TCRM and laparoscopic resection of myoma (LM). 11,12 In 2022, Zhang et al compared LM and TCRM for submucosal myomas. A total of 136 patients with uterine submucosal fibroids were enrolled.…”

Section: Guidelines Of the International Society Of Gynecologicalmentioning

confidence: 99%

Optimal treatment options for uterine submucosal fibroids: Percutaneous microwave ablation versus transcervical resection of myoma

Jin

Chen

et al. 2023

J of Clinical Ultrasound

View full text Add to dashboard Cite

Objectives To compare the efficacy and safety of percutaneous microwave ablation (PMWA) and transcervical resection of myoma (TCRM) for submucosal fibroids. Methods From January 2019 to January 2021, we conducted a randomized controlled study involving patients with symptomatic uterine submucosal fibroids. Questionnaires were also used to measure the uterine fibroid symptom (UFS) scores and quality of life (QoL) scores before and after treatment at 3, 6, and 12 months. Outcomes, adverse events, hemoglobin recovery, and submucosal fibroid volume of both groups were also compared. Operation time, amount of bleeding, hospital stay time, and occurrence of complications were compared in groups with fibroids of different lengths. Results Follow‐up after surgery showed that UFS scores at 3, 6, and 12 months were significantly lower in each group, while QoL scores increased significantly. For fibroids less than 3 cm, surgical time was 34.2 ± 9.9 min, incidence of perioperative complications was 4.2%, and both decreased significantly, compared to the surgical time of the PMWA group (40.0 ± 8.1 min) and incidence of perioperative complications (24%; p < .05 for both). For uterine submucosal fibroids >5 cm, the operation time in the PMWA group was 92.7 ± 16.0 min, intraoperative bleeding volume was 22.7 ± 6.4 mL, and hospital stay was 2.7 ± 1.1 days, which were significantly less than the procedural time (107 ± 11.9 min), intraoperative bleeding loss (45.9 ± 12.8 mL), and length of hospital stay (5.0 ± 1.1 days) in the TCRM group. The differences were statistically significant (p < .05). Conclusions PMWA and TCRM were both effective treatments for uterine submucosal fibroids. For fibroids shorter than 3 cm in length, especially pedicled submucosal fibroids, TCRM has absolute advantages; however, for uterine submucosal fibroids >5 cm, PMWA avoids perioperative complications, such as uterine perforation, water poisoning syndrome, and the need for repeat surgery, and is considered the preferred mode of treatment. Therefore, personalized treatment should be used for different patients with uterine submucosal fibroids.

show abstract

Laparoscopic Myomectomy: An Alternative Approach to Tackling Submucous Myomas?

Cited by 7 publications

References 23 publications

The tip of the iceberg fibroid effect; when to avoid transcervical resection. The utilisation of 3D pelvic ultrasonography for fibroid mapping.

The tip of the iceberg fibroid effect; when to avoid transcervical resection. The utilisation of 3D pelvic ultrasonography for fibroid mapping.

Barbed suture and gastrointestinal surgery. A retrospective analysis

Optimal treatment options for uterine submucosal fibroids: Percutaneous microwave ablation versus transcervical resection of myoma

Contact Info

Product

Resources

About