Laparoscopic Myomectomy: Technique, Complications, and Ultrasound Scan Evaluations

Landi, Stefano; Zaccoletti, Riccardo; Ferrari, Luisa; Minelli, Luca

doi:10.1016/s1074-3804(05)60583-x

Cited by 77 publications

(66 citation statements)

References 20 publications

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“…In the later course of the study, even more complicated situations were completed successfully. Studies have shown that the rate of conversion varies between 1 and 11% [4,5] and can be reduced by more than half after gaining experience [1]. Reasons for conversion were related to lack of cleavage plan (e.g., in the second patient in our study, in which case we needed to perform a vaginal hysterectomy 2 days later), associated pathology, hemorrhage, and number and size of fibroids.…”

Section: Discussionmentioning

confidence: 86%

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Complications in laparoscopic myomectomy

et al. 2006

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Section: Discussionmentioning

confidence: 86%

“…Landi et al [5] reported a decrease in hemoglobin concentration of 1.38 ± 0.93 mg/dl when hemostasis was achieved by bipolar coagulation. In large case series, the transfusion rate was 0.8-0.9% [2,5].…”

Section: Discussionmentioning

confidence: 99%

Complications in laparoscopic myomectomy

et al. 2006

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“…However, at the moment, it is only offered to a minority of women. It is a complex procedure with a steep learning curve requiring different skills than open surgery because of a two-dimensional representation of the operative site, limited tactile feedback, difficult suturing techniques, and the need for surgeons to learn different hand-eye coordination skills [13,19]. Our study shows that there is no difference in parameters such as blood loss and operation duration after the learning curve is reached.…”

Section: Discussionmentioning

confidence: 73%

In Laparoscopic Myomectomy, Does a Caseload of 100 Patients During the Learning Curve Produce a Significant Improvement in Performance Measures?

Shah

Odejinmi

Agarwal

2015

J Obstet Gynecol India

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About the Author AbstractPurpose Laparoscopic myomectomy (LM) offers considerable advantages over open myomectomy; however, LM is technically complex and associated with a steep learning curve. Few studies have evaluated the effect of the learning curve, and the limitations of most of these studies were the number of women included and the multiplicity of surgeons undertaking the procedure. The aim of this study is to evaluate the effect of a caseload of 100 patients during the learning curve of a single experienced surgeon performing LM. 123Both the groups were very similar with regard to the number, size and weight of myomas removed, the duration of surgery, and blood loss. More women were sent home within 24 h in the second group (27 vs 10.2 %, p = 0.002). Group A suffered significantly higher complication rates compared to Group B (11 vs 7, p \ 0.05). The laparotomy conversion rate was 1.5 % (3 in Group A, none in Group B).Conclusions After a caseload of 100 patients during the learning curve, there was no difference in outcomes apart from increased confidence to discharge patients after 24 h and reduced complication rates. Thus, mere numbers do not influence the number/size of fibroids removed, operating time, or blood loss but do influence complication rates and post-operative discharge times.

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“…Ello se hace más evidente cuando se compara pacientes operadas por mioma menor de 5 cm. Cabe señalar, que nuestros resultados por laparoscopia son comparables a series internacionales en cuanto a tiempo quirúrgico y tasa de complicaciones (14,(16)(17)(18). Recientemente se publicó un estudio randomizado multicéntrico comparando la miomectomía laparoscópica con la realizada por minilaparotomía, que demostró beneficios a favor de la minilaparotomía en términos del tiempo de enucleación del mioma y número de histerotomías.…”

Section: Discussionunclassified

Miomectomía Abdominal Versus Miomectomía Laparoscópica: Experiencia Preliminar Del Hospital Clínico De La Pontificia Universidad Católica De Chile

Sigüenza²,

et al. 2009

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: Múltiples pacientes requieren un manejo conservador del mioma uterino. Muchas de ellas no han completado su paridad, y otras no desean la remoción del útero preocupadas del impacto que esa alternativa tenga en su vida sexual. Objetivos: Evaluar nuestra experiencia en pacientes miomectomizadas mediante laparoscopia o laparotomía y revisar la literatura para definir las ventajas de cada técnica y recomendaciones para su indicación. Método: Estudio prospectivo, no randomizado, de pacientes miomectomizadas en el Servicio de Ginecología del Hospital Clínico de la Universidad Católica de Chile, durante el período noviembre de 2007 y mayo de 2008. Resultados: La población incluida fue de 43 casos; 16 casos correspondieron a miomectomía laparoscópica (37,2%) y 27 a miomectomía por laparotomía (67,8%). La miomectomía por laparotomía se realizó en 40% de los casos utilizando una incisión transversa mínima. Esta vía de abordaje fue más frecuentemente utilizada cuando se trataba de miomas de gran tamaño o de múltiples miomas. En nuestra serie, la miomectomía laparoscópica se asociaría a un menor requerimiento de analgesia. No hay diferencias en la frecuencia de complicaciones, tiempo operatorio y estadía hospitalaria entre ambas técnicas, cuando se trata de miomas operados menores de 5 cm. Conclusión: Nuestros resultados sugieren que la miomectomía por laparotomía es una técnica segura que debiese privilegiarse cuando se trata de miomas grandes y múltiples. La laparoscopia es igualmente segura reservada para casos bien seleccionados y cirujanos experimentados en el procedimiento.PALABRAS CLAVE: Mioma, miomectomía, cirugía, laparoscopia, complicaciones SUMMARY Background: Multiple patients ask for a conservative management of uterine fibroids. Some of the patients have not completed their parity at the time of surgery, and others do not want an hysterectomy worried about de impact of this procedure in their sexual life. Objectives: The objective of this study was to evaluate our experience in the short term surgical results of patients undergoing a laparoscopic or abdominal myomectomy. We also did a literature review to define the advantages for each technique and their indications. Methods: A prospective, non-randomized study comparing short term surgical outcomes in patients undergoing laparoscopic versus abdominal myomectomy in the Gynecology Service of the Clinical Hospital of the Pontificia Universidad Católica de Chile, between November 2007 and May 2008. Results: Forty-three patients undergoing myomectomy in our centre were analyzed. 16 of them were approached by laparoscopy (37.2%)

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Laparoscopic Myomectomy: Technique, Complications, and Ultrasound Scan Evaluations

Cited by 77 publications

References 20 publications

Complications in laparoscopic myomectomy

Complications in laparoscopic myomectomy

In Laparoscopic Myomectomy, Does a Caseload of 100 Patients During the Learning Curve Produce a Significant Improvement in Performance Measures?

Miomectomía Abdominal Versus Miomectomía Laparoscópica: Experiencia Preliminar Del Hospital Clínico De La Pontificia Universidad Católica De Chile

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