Prospective Evaluation for the Feasibility and Safety of Vaginal Birth after Laparoscopic Myomectomy

Kumakiri, Jun; Takeuchi, Hiroyuki; Itoh, Shigeru; Kitade, Mari; Kikuchi, Iwaho; Shimanuki, Hiroto; Kumakiri, Yuko; Kuroda, Keiji; Takeda, Satoru

doi:10.1016/j.jmig.2008.04.008

Cited by 61 publications

(43 citation statements)

References 18 publications

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“…62 More recent and larger studies albeit of selected patients have attempted to shed more light on this issue, including the safety of labor after laparoscopic myomectomy. 63 This study lends support to the safety of judicious oxytocin administration in these selected cases. 64 Paul et al 65 retrospectively evaluated outcomes among 31 women who underwent labor after laparoscopic myomectomy and single-layer closure and recorded no URs.…”

Section: Vaginal Delivery After Prior Myomectomysupporting

confidence: 59%

Uterine Rupture as a Source of Obstetrical Hemorrhage

Landon

2010

Clinical Obstetrics &Amp; Gynecology

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Uterine rupture is an important cause of obstetrical hemorrhage associated with morbidity for mother and fetus. Risk factors should be discussed in the counseling process. Intrapartum findings including maternal condition, fetal heart rate monitoring, and uterine activity may prove helpful in making the diagnosis of a dehiscence or rupture, but ultimately this requires some degree of suspicion by the labor and delivery team. As in any case of acute obstetrical emergency, preparation and timely mobilization of all necessary personnel is key to optimizing outcome.

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Section: Vaginal Delivery After Prior Myomectomysupporting

confidence: 59%

Uterine Rupture as a Source of Obstetrical Hemorrhage

Landon

2010

Clinical Obstetrics &Amp; Gynecology

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“…Because myomectomy is commonly performed in patients who desire children, it is important to preserve the patient’s ability to become pregnant and safely give birth; therefore, the possibility of vaginal delivery [23] should be considered. Because barbed sutures have been developed only recently, there are no reported studies of post-LM parturient outcomes.…”

Section: Discussionmentioning

confidence: 99%

Long unidirectional barbed suturing technique with extracorporeal traction in laparoscopic myomectomy

et al. 2014

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BackgroundMyomectomy is now often performed laparoscopically rather than by laparotomy to alleviate the risk of postoperative adhesions and reduce postoperative pain. However, intracorporeal knot-tying under direct laparoscopy is difficult and requires proficiency. We conducted a retrospective study comparing the results of a long unidirectional barbed suturing technique (with V-Loc180 suture) and the results of conventional suturing as applied to laparoscopic myomectomy.MethodsIn women who underwent laparoscopic myomectomy in our university hospital between January 2011 and April 2013, uninterrupted suturing of 2 or more layers was performed. These women were divided into 2 groups according to the method of suturing: those in whom standard absorbable sutures were used (group P, n =42) and those in whom our suturing technique was used (group V, n =41). Patient characteristics and surgical variables were compared between the 2 groups.ResultsNo significant between-group difference was observed in age (p = .975), body mass index (p = .778), GnRHa administration (p = .059), intraoperative vasopressin dose (p = .364), intraoperative blood loss (73.8 ± 64.1 vs. 59.3 ± 54.0 mL, respectively; p = .199), myoma mass (212.6 ± 133.3 vs. 208.3 ± 198.4 g, respectively; p = .134), ΔHb (p = .517), or postoperative hospital stay (p = .314). Operation time (mean ± SD) was significantly shorter for group V (71.2 ± 22.9 minutes; range, 28.0–110.0 minutes; p < .001) than for group P (94.4 ± 27.2 minutes; range, 53.0–165.0 minutes). No patient required intraoperative transfusion or conversion to laparotomy.ConclusionsOur suturing technique exploits the features of unidirectional barbed sutures and can be used in the same way as the conventional method when performing continuous suturing for laparoscopic myomectomy. Our data suggest that operation time can be reduced by as much as 25% with this new technique.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2482-14-84) contains supplementary material, which is available to authorized users.

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“…10,11,16 It is the most appropriate technique for conserving fertility among the treatment options for uterine myomas. Patients undergoing myomectomy can still expect to become pregnant after the operation.…”

Section: Discussionmentioning

confidence: 99%