Surgical treatment: Myomectomy and hysterectomy; Endoscopy: A major advancement

Thubert, Thibault; Foulot, H.; Vinchant, Marie; Santulli, Piétro; Marzouk, Paul; Borghese, Bruno; Chapron, Charles

doi:10.1016/j.bpobgyn.2015.11.021

Cited by 29 publications

(28 citation statements)

References 98 publications

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“…A number of techniques have been devised to reduce operative blood loss during myomectomy. Two categories of interventions are available: (a) pharmacological interventions, such as oxytocin, vasopressin, ergometrine, sulprostone, misoprostol, or gonadotropin‐releasing hormone (GnRH) agonists, and (b) vascular interventions on uterine or ovarian vessels, such as tying, clamping, or embolization . Although among these, intraoperative local injection of vasopressin causing vasoconstriction is most often used, some serious adverse events have also been reported following the use of vasopressin .…”

Section: Discussionmentioning

confidence: 99%

Comparison between the vascular control technique and conventional technique for reducing operative blood loss during robot‐assisted myomectomy

Song

Han

Sung

2019

Robotics Computer Surgery

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Background: This retrospective study aimed to compare the surgical outcomes and morbidity of the vascular control technique in robotic myomectomy with the conventional technique.Methods: Thirty-two consecutive patients who underwent robotic myomectomy using laparoscopic vascular clamps in 2017 to 2019 (the practice change cohort) were retrospectively comparted with 32 case-matched consecutive patients who underwent the conventional robotic myomectomy (the historical cohort). The primary outcome was the operative blood loss and hemoglobin change. Results:The two cohorts had similar baseline characteristics. The mean operative blood loss and hemoglobin changes were lower in the practice change cohort than in the historical cohort (P < .001 and P = .005, respectively). Other postoperative outcomes were similar between two cohorts. Conclusion:The vascular control technique in robotic myomectomy appears to be effective and safe in the management of selective patients with symptomatic myomas. KEYWORDS blood loss, robotic myomectomy, uterine myomas, vascular control 1 | INTRODUCTION Uterine myoma affects 25% of women worldwide and is the most common benign uterine tumor in women of reproductive age. 1,2 If the medical treatments are not effective for the women who have symptoms or infertility, surgical treatments should be considered. Surgical treatments for uterine myoma included myomectomy for women who desire pregnancy in the future or want to preserve their uterus, and hysterectomy for those who have completed childbearing. 3 The accomplishment of myomectomy by either conventional laparoscopy or robot-assisted laparoscopy has been often questioned for causing excessive operative blood loss and, as a direct consequence, blood transfusion, conversion to hysterectomy, postoperative anemia, and delayed recovery. 1-4 Therefore, various surgical techniques have been devised to reduce blood loss during myomectomy in more safe and faster way. 5 There are many recent studies about new methods how to achieve simultaneous temporary occlusion of both uterine and ovarian (or utero-ovarian) arteries during myomectomy more effectively in regard to the surgical time and complications. 6,7 However, the application of this technique to clinical practice (especially in robotic myomectomy) has not been investigated in terms of its efficacy and safety. Therefore, we designed this study to evaluate the feasibility and safety of the vascular control technique in robot-assisted laparoscopic myomectomy and compare the surgical outcomes and morbidity to the conventional techniques. (Figure 1)

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Section: Discussionmentioning

confidence: 99%

Comparison between the vascular control technique and conventional technique for reducing operative blood loss during robot‐assisted myomectomy

Song

Han

Sung

2019

Robotics Computer Surgery

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“…Uterine leiomyomas are benign tumors which arise in the uterine myometrial smooth muscle and are clinically apparent in about 20% to 25% of women in reproductive age 6,10,11 . Surgical intervention may be indicated in women with large, symptomatic uterine leiomyomas 7,12 .…”

Section: Discussionmentioning

confidence: 99%

“…symptomatic and resistant to medical management or interferes with female reproduction 1,4 . A current management strategy involves surgical intervention depending on the patient's age, the desire for fertility preservation or avoidance of radical surgery, such as hysterectomy 1,5,6 . Myomectomy could be performed abdominally, laparoscopically or by robotic surgeries 1,4,7 .…”

Section: Bahrain Med Bull 2016; 38(4):204 -207mentioning

confidence: 99%

Intra and Postoperative Morbidity Associated with Myomectomy

Bushaqer¹,

Jama²,

Turki³

2016

BMB

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Myomectomy as an organ-preserving procedure has become an established alternative to hysterectomy 1-3. An increasing number of women in their fourth to fifth decade request conservative surgery to preserve their reproductive potential 2,3. New advances in assisted reproductive techniques permit women in later reproductive years to bear a child if the uterus is still intact. Submucous and intramural myoma decreases fertility and its removal is beneficial and necessary when the myoma is

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“…For many years, surgical management remained the gold standard for the treatment of symptomatic UFs [12][13][14][15][16]. At present, when the age at which women become mothers shows a constantly growing trend [17], a total deprivation of fertility, which occurs with hysterectomy, often becomes an unacceptable proposal [18,19].…”

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confidence: 99%