Laparoscopy vs laparoscopically assisted myomectomy in the management of uterine myomas: a prospective study

Abdominal myomectomy—a safe procedure in an ambulatory setting

“…Another study compared 76 patients treated by laparoscopically assisted myomectomy and 40 patients treated by laparoscopic myomectomy (24). Operative time was significantly less in the laparoscopically assisted minilaparotomy group, but estimated blood loss was significantly more (24). There were no significant differences in hospital stays (mean of 1.2 days in both groups) (24).…”

“…When compared with the classic laparotomy approach, it reported that minilaparotomy and laparoscopically assisted minilaparotomy myomectomy had similar operation times (86-92 vs. 91 minutes) but decreased hospital stays (82-119 vs. 141 hours) (11). Another study compared 76 patients treated by laparoscopically assisted myomectomy and 40 patients treated by laparoscopic myomectomy (24). Operative time was significantly less in the laparoscopically assisted minilaparotomy group, but estimated blood loss was significantly more (24).…”

Laparoscopically assisted myomectomy

“…In contrast to conventional laparoscopy, LAM allows palpation so that the surgeon can identify small intramural myomas with his or her fingers, an advantage not present in conventional laparoscopy (5). This technique also avoids extensive use of thermal energy to achieve hemostasis laparoscopically, which may compromise uterine tissue (5).…”

“…Also, LAM makes minimally invasive myomectomy accessible to more practitioners, simplifying the procedure by facilitating suturing and reducing operative time (5,6). In contrast to conventional laparoscopy, LAM allows palpation so that the surgeon can identify small intramural myomas with his or her fingers, an advantage not present in conventional laparoscopy (5). This technique also avoids extensive use of thermal energy to achieve hemostasis laparoscopically, which may compromise uterine tissue (5).…”

“…This technique may facilitate multilayer uterine closure in cases of very large or multiple myomas, and LAM could enable the majority of surgeons to reduce the risks associated with inadequate laparoscopic closure of the uterus (2,5). Also, LAM makes minimally invasive myomectomy accessible to more practitioners, simplifying the procedure by facilitating suturing and reducing operative time (5,6). In contrast to conventional laparoscopy, LAM allows palpation so that the surgeon can identify small intramural myomas with his or her fingers, an advantage not present in conventional laparoscopy (5).…”