Laparoscopic myomectomy: Methods to control bleeding

Abstract

Most of the surgeons find it difficult to perform myomectomy when it bleeds during the procedure as it becomes difficult to get into the correct plane of dissection. If this bleeding or blood staining of tissues is prevented it will be easier to get into the correct plane of dissection. In several studies, it is found that bilateral uterine artery ligation, at origin, does not interfere with future fertility as the end vessels and collaterals of the uterus are not interfered with. As no energy source is used to incise the myoma once Vasopressin has been used, the myomectomy scar integrity is better, as noted by various surgeons.

The concern about the educational quality of online videos on laparoscopic myomectomy

“…Intraoperative vasopressin injection, another technique for decreasing intraoperative blood loss, was also underemphasized 14 . Even though preoperative (correction of anemia and GnRHa usage) and perioperative precautions (vasopressin injection, uterine artery ligation, and using barbed suture) are very important for better surgical outcomes, they were not emphasized 15 . There was also inconsistency between the number of suture layers in the myometrium during the wound closure, which determines the risk of uterine rupture in subsequent pregnancies.…”