Vasopressin Administration During Laparoscopic Myomectomy: A Randomized Controlled Trial

Cohen, Sarah; Kc, Wang; Ar, Gargiulo; Srouji, Serene S.; Goggins, ER; Solnik, Jonathon; F, Tu; Senapati, S.; Hur, H.-C.; Einarsson, J.I.

doi:10.1016/j.jmig.2015.08.110

Cited by 8 publications

(5 citation statements)

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“…6,16,17 No major operative complications were reported in any case of the current study, but transient intra-operative bradycardia was seen in two cases (one in vasopressin group and another in the OA group), they were immediately managed by intra-venous atropine. Surprisingly, the injected medication volume in these two patients was not high compared to many other cases, where the doses was higher due to more and bigger myomata.…”

Section: Discussionmentioning

confidence: 57%

A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

Badawy

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.

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Section: Discussionmentioning

confidence: 57%

A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

Badawy

2017

Int J Reprod Contracept Obstet Gynecol

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“…It improves the surgeons’ ability to develop tissue planes and compresses vessels minimizing bleeding and facilitating fibroid enucleation. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic myomectomy of a 4.2 kg fibroid with assistance of a minilaparotomy

Conrad

Saar

Pacquée

et al. 2018

Gynecol Minim Invasive Ther

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The improved cosmesis and recovery from minimally invasive techniques has seen a dramatic rise in its popularity. Unfortunately, the laparoscopic myomectomy for large fibroids presents a unique challenge to the surgeon. It is reputed to be difficult and time consuming, with a high risk of conversion to laparotomy. As laparoscopic techniques improve, the laparoscopic myomectomy for larger fibroids is becoming more feasible. This article outlines the case of laparoscopic removal of a 4.2 kg fibroid with the assistance of a minilaparotomy.

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“…Three 5-mm accessory ports, 2 on the left, 9-10 cm apart and 1 on right, higher than left lower port are taken. Dilute vasopressin 20 units in 200 ml of normal saline is injected [3], quantity of drug injected depends on the size of fibroid. Horizontal incision on bulge of the myoma is made with monopolar spatula or active blade of harmonic scalpel.…”

Section: Technique Of Laparoscopic Myomectomy-151 Cases (Group A)mentioning

confidence: 99%

Laparoscopic In-Bag Morcellation Compared with Conventional Morcellation of Myomas and Uterus with Myomas

Trivedi¹,

Trivedi²,

Patil

2019

J Obstet Gynecol India

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Study Objective To evaluate contained bag electromechanical morcellation for removal of myomas and uterus with myomas, laparoscopically (Study group B), and compare it with uncontained laparoscopic morcellation (Control group A) in patients with similar parameters done earlier. Design Retrospective Cohort Comparative Study (Canadian Task Force 2-1).Setting Advanced Gynaecologic MAS, university recognized tertiary centre, Mumbai, India. Patients 720 women had laparoscopic removal of myomas or large uterus with myomas during a study period of 6 years (from 13 May 2012 to 14 August 2018) with contained bag electromechanical or conventional morcellation. Interventions Laparoscopic hysterectomy, laparoscopic myomectomy, conventional uncontained morcellation, contained in-bag morcellation. Main Outcomes Measures Laparoscopic contained in-bag morcellation was compared with conventional morcellation of myomas and uterus with large myomas during a study period of 6 years. Parameters assessed were operating time, time for insertion of bag, morcellation of tissues and removal of bag, blood loss, complications, conversion to open surgery and histopathologic findings of tissues. In Group A, in the first 3 years, 355 women underwent uncontained morcellation. Myoma size and weight varied from 5 cm to 26 cm and 200 g to 3740 g respectively. The myoma number ranged from 1 to 18. No case of leiomyosarcoma was reported. In Group B, in the next 3 years, 365 women underwent contained bag morcellation in 196 myomectomy cases and 169 hysterectomy cases. Myoma size and weight varied from 4 cm to 20 cm and 200 g to 2100 g respectively. The number of myomas varied from 1 to 17. Results and ConclusionLaparoscopic contained bag morcellation for myomas and uterus with large myomas were evaluated. In myomectomy group both conventional and in bag laparoscopic morcellation were comparable in terms of duration of the surgery and blood loss. When all cases ( hysterectomy and myomectomy combined together) and cases of hysterectomy with large fibroid were studied, laparoscopic in bag morcellation took less operative time and there was statistically significant difference in operative time . No case of leiomyosarcoma was found in our study of 720 cases of myomas or uterus with large myomas.

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Vasopressin Administration During Laparoscopic Myomectomy: A Randomized Controlled Trial

Cited by 8 publications

References 0 publications

A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

Laparoscopic myomectomy of a 4.2 kg fibroid with assistance of a minilaparotomy

Laparoscopic In-Bag Morcellation Compared with Conventional Morcellation of Myomas and Uterus with Myomas

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