Laparoscopic transient uterine artery occlusion and myomectomy for symptomatic uterine myoma

Liu, Lubin; Li, Yuyan; Xu, Huilin; Chen, Yong; Zhang, Guangjin; Liang, Zhiqing

doi:10.1016/j.fertnstert.2010.05.006

Cited by 44 publications

(18 citation statements)

References 25 publications

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“…39,40 Spontaneous abortions occurred in nearly 19% of the pregnancies, which is similar to the standard laparoscopic myomectomy studies performed. [41][42][43][44] Preterm delivery prior to 35 weeks of gestation occurred in 17.4% and were found to be associated with a greater number of myomas removed and anterior location of the largest incision, while no association was found for other myoma characteristics. 39 Robotic myomectomy is a viable alternative to abdominal myomectomy and standard laparoscopic myomectomy.…”

Section: Leiomyomamentioning

confidence: 94%

Robotics and Reproductive Surgery

2017

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Robotic technology applied to laparoscopy augments the armamentarium of the reproductive specialist. Uterine leiomyomas, adenomyosis, endometriosis, adnexal masses, sterilization reversal, and fertility preservation techniques can all be addressed with a robotic surgery skill set. Additionally, new approaches with single site and natural orifice surgery will continue to maximize advanced opportunities for safe, effective, and cosmetically conscious (patient-centered) approaches to surgical care. Enhanced postoperative recovery pathways are fully adaptable to these robotic procedures and improve patient acceptability while controlling costs.

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Section: Leiomyomamentioning

confidence: 94%

Robotics and Reproductive Surgery

2017

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“…Multiple prospective studies have found that both suture ligation and vascular clip application at the uterine arteries significantly reduced EBL (MD: À94 to À229 mL) without a significant impact on fertility outcomes. [132][133][134][135][136] De novo adhesion formation after LM averages 41.3% and can have a significant impact on future fertility. 137 Aside from optimal surgical technique and hemostasis, several adhesion barriers are available in the United States for adhesion prevention.…”

Section: Preoperative Treatmentmentioning

confidence: 99%

Minimally Invasive Approaches to the Surgical Management of Fibroids

Wang

2017

Semin Reprod Med

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Uterine fibroids, as the most common benign neoplasm of the female reproductive tract, can significantly impact a woman's quality of life through abnormal uterine bleeding, infertility, and bulk symptoms. When medical therapy for symptomatic fibroids fails, surgery is the recommended treatment. While a hysterectomy through laparotomy was historically the first-line surgical approach for fibroids, multiple minimally invasive and uterine-sparing techniques are now available. An evidence-based literature review of the following minimally invasive approaches is detailed in this article: hysteroscopic myomectomy, laparoscopic and robotically assisted myomectomy, laparoscopic and robotically assisted hysterectomy, and ultrasound-guided radiofrequency ablation. For each approach, this review discusses the indications, patient selection, adjunct preoperative treatment modalities, instrumentation, techniques, and pertinent intraoperative considerations such as fluid management, interventions to reduce blood loss, antiadhesion barriers, and tissue extraction. Perioperative benefits, long-term outcomes including recurrence and fertility, and comparisons of outcomes among the various approaches are outlined as well. With continued technological advancements and surgical innovations, minimally invasive techniques will become the mainstay of surgical management for symptomatic fibroids to provide high-quality patient-centered care.

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“…Akinola et al found the uterine artery ligation to be as effective as UAE, while Hald et al found it to be less effective in direct comparison to UAE 54,55. The procedure has also been tried in association with myomectomy and is reportedly associated with less introperative blood loss compared with myomectomy carried out without it 56. The procedure may reduce postpartum blood loss and minimize the need for future surgery in pregnant women with uterine myomas, who are undergoing cesarean section 57.…”

Section: Surgical Managementmentioning

confidence: 99%

Current and emerging treatments for uterine myoma – an update

Duhan¹

2011

IJWH

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Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indications. Hysterectomy has its place in myoma management in its definitiveness. However, myomectomy, rather than hysterectomy, should be performed when subsequent childbearing is a consideration. Preoperative gonadotropin-releasing hormone analog treatment before myomectomy decreases the size and vascularity of the myoma but may render the capsule more fibrous and difficult to resect. Uterine artery embolization is an effective standard alternative for women with large symptomatic myomas who are poor surgical risks or wish to avoid major surgery. Its effects on future fertility need further evaluation in larger studies. Serial follow-up without surgery for growth and/or development of symptoms is advisable for asymptomatic women, particularly those approaching menopause. The present article is incorporated with multiple clear clinical photographs and simplified elaboration of the available management options for these tumors of uterine smooth muscle to facilitate clear understanding.

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Laparoscopic transient uterine artery occlusion and myomectomy for symptomatic uterine myoma

Cited by 44 publications

References 25 publications

Robotics and Reproductive Surgery

Robotics and Reproductive Surgery

Minimally Invasive Approaches to the Surgical Management of Fibroids

Current and emerging treatments for uterine myoma – an update

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Laparoscopic transient uterine artery occlusion and myomectomy for symptomatic uterine myoma

Cited by 44 publications

References 25 publications

Robotics and Reproductive Surgery

Robotics and Reproductive Surgery

Minimally Invasive Approaches to the Surgical Management of Fibroids

Current and emerging treatments for uterine myoma &ndash; an update

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Current and emerging treatments for uterine myoma – an update