Laparoscopic Triple-tourniquet Constriction: A Convenient Way for Minimizing Blood Loss during Myomectomy

Kuo, Hsing‐Chun; Lin, Wei-Li; Pai, Angel Hsin-Yu; Yen, Chih‐Feng

doi:10.1016/j.jmig.2022.08.009

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…In addition, different pharmacological (such as vaginal or rectal misoprostol, intramyometrial vasopressin injection, bupivacaine, and epinephrine subserosal injection, intravenous oxytocin infusion) hemostatic techniques proved to be useful to reduce intraoperative blood loss [41], although comparative analyses do not allow to identify the best strategy over the others, and we should take into account that intramyometrial vasopressin injection may cause adverse cardiopulmonary events. Similarly, some non-pharmacological hemostatic techniques, such as the use of tissue sealants [86], temporary uterine artery occlusion [87], and tourniquet loop [88], may also be considered adequate strategy to reduce intraoperative blood loss and, consequently, the need for transfusion and the risk of unplanned hysterectomy. From a technical perspective, both single-site [89] and robotic [90] approaches can be considered feasible and safe options: although both were not associated with longer operative time compared with standard laparoscopic myomectomy, robotic surgery is associated with higher costs.…”

Section: Laparoscopic Myomectomymentioning

confidence: 99%

Management of Uterine Fibroids and Sarcomas: The Palermo Position Paper

Laganà,

Romano,

Vanhie

et al. 2024

Gynecol Obstet Invest

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Background Uterine fibroids are benign monoclonal tumors originating from the smooth muscle cells of the myometrium, constituting the most prevalent pathology within the female genital tract. Uterine sarcomas, although rare, still represent a diagnostic challenge and should be managed in centers with adequate expertise in gynecological oncology. Objectives This article is aimed to summarize and discuss cutting-edge elements about the diagnosis and management of uterine fibroids and sarcomas. Methods This paper is a report of the lectures presented in an expert meeting about uterine fibroids and sarcomas, held in Palermo in February 2023. Outcome Overall, the combination of novel molecular pathways may help to combine biomarkers and expert ultrasound for the differential diagnosis of uterine fibroids and sarcomas. On the one hand, molecular, and cellular maps of uterine fibroids and matched myometrium may enhance our understanding of tumor development compared to histologic analysis and whole tissue transcriptomics and support the development of minimally invasive treatment strategies; on the other hand, ultrasound imaging allows in most of the cases a proper mapping the fibroids and to differentiate between benign and malignant lesions, which needs appropriate management. Conclusions and Outlook The choice of uterine fibroid management, including pharmacological approaches, surgical treatment, or other strategies such as High-Intensity Focused Ultrasound (HIFU), should be carefully considered taking into account the characteristics of the patient and reproductive prognosis.

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Section: Laparoscopic Myomectomymentioning

confidence: 99%

Management of Uterine Fibroids and Sarcomas: The Palermo Position Paper

Laganà,

Romano,

Vanhie

et al. 2024

Gynecol Obstet Invest

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“…Dumitraşcu et al performed a review showing the importance of surgical technique when performing laparoscopic myomectomy. This approach is suitable for complex cases also, and techniques to minimize blood loss during surgery can be applied ( 7 – 13 ) Balulescu et al presented the results of a clinical trial that investigated the efficiency of temporary occlusion of the hypogastric artery during laparoscopic myomectomy ( 9 ). Hertling et al demonstrated the benefit of uterine artery embolisation before laparoscopic myomenucleation of large fibroids.…”

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confidence: 99%

Editorial: Minimally invasive surgery in benign gynecological pathology

Pirtea

2024

Front. Med.

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Validation of uterine artery embolization before surgical laparoscopic myomenucleation compared to single surgical laparoscopic myomenucleation for the treatment of large fibroids and uterus myomatosus

2023

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AimTo determine the efficacy of preoperative uterine artery embolization (uterine artery embolization; UAE) prior to elective laparoscopic fibroid removal compared to single laparoscopic fibroid removal in women with large uterine fibroids and women with uterus myomatosus.Material and methodsA total of 202 women with symptomatic uterine fibroids who were scheduled for elective fibroid enucleation were included in this retrospective, monocentric, non-randomized study. Two procedures were compared: women who received percutaneous UAE 24 h prior to elective laparoscopic fibroid eviction for large uterine fibroids (>6 cm) and uterus myomatosus. And women who received laparoscopic fibroid enucleation alone for large uterine fibroids and uterus myomatosus. Outcome parameters for effectiveness were the hospital stay, the operating time and the intraoperative blood loss.ResultsWomen who underwent preoperative percutaneous embolization of the uterine arteries, both for large fibroids and uterus myomatosus, had significantly less blood loss, shorter hospital stays, and shorter operating times.ConclusionsEspecially women with large uterine fibroids and women with uterus myomatosus after having children can benefit from the combination therapy of preoperative percutaneous uterine embolization with subsequent laparoscopic myoma enucleation.

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Laparoscopic Triple-tourniquet Constriction: A Convenient Way for Minimizing Blood Loss during Myomectomy

Cited by 4 publications

References 4 publications

Management of Uterine Fibroids and Sarcomas: The Palermo Position Paper

Management of Uterine Fibroids and Sarcomas: The Palermo Position Paper

Editorial: Minimally invasive surgery in benign gynecological pathology

Validation of uterine artery embolization before surgical laparoscopic myomenucleation compared to single surgical laparoscopic myomenucleation for the treatment of large fibroids and uterus myomatosus

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