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Surgical Endoscopy

, 25:2362 | Cite as

Highly effective method for myoma excision and suturing in laparoscopic myomectomy

  • Yu-Jin Koo
  • Heung-Seop Song
  • Kyong-Shil Im
  • Hyun-Ju Jung
  • Yong-Soon KwonEmail author
Multimedia Manuscript

Abstract

Background

Laparoscopic myomectomy rather than abdominal myomectomy has been well documented as a treatment option for uterine myomas. However, laparoscopic myomectomy has serious limitations in two of its steps: excision of myoma with strong traction and suturing of the uterine defect. These steps are a challenge even for experienced surgeons. The authors introduce a simple but highly effective technique for excision of myoma and suturing using standard instrumentation in laparoscopic myomectomy.

Methods

After incision of the myometrium, the myoma pseudocapsule is separated by insertion of the dissector tip and scissors into the myoma. After completion of myoma enucleation, the surgeon makes a U-shaped hole of suture material with forceps for an interlocking suture, and the first assistant holds the stitch to maintain the suture tension thoughtout the repair.

Results

From February 2010 to August 2010, 43 patients with a diagnosis of uterine myoma underwent laparoscopic myomectomy by single surgeon using the aforementioned procedure. The mean diameter of the myoma was 6.3 cm (range, 4–9 cm), and multiple myomas were observed in 19 cases (44.2%). As a result, the mean operative time was 75.9 min (range, 35–155 min), and the hospital stay was 2.7 days (range, 2–5 days). The blood loss was 137.2 ml (range, 50–250 ml), and the hemoglobin decline on the first day after surgery was 1.5 mg/dl (range, 0.1–3.6 mg/dl). Postoperative fever higher than 37.7°C was the most commonly observed morbidity (ten patients, 23.3%). How- ever, no cases had conversion to laparotomy or major complications requiring reoperation or readministration during the mean follow-up period of 5.9 months (range, 3–9 months).

Conclusions

Laparoscopic myomectomy can be performed easily and effectively by forceps insertion and continuous interlocking suture using standard instruments.

Keywords

Excision Laparoscopy Myomectomy Suturing 

Supplementary material

Supplementary material 1 (MPG 72556 kb)

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Yu-Jin Koo
    • 1
  • Heung-Seop Song
    • 1
  • Kyong-Shil Im
    • 2
  • Hyun-Ju Jung
    • 2
  • Yong-Soon Kwon
    • 3
    Email author
  1. 1.Department of Obstetrics and Gynecology, Cheil General Hospital and Women’s Healthcare CenterKwandong University College of Medicine SeoulKorea
  2. 2.Department of Anesthesiology and Pain Medicine, College of MedicineCatholic UniversitySeoulKorea
  3. 3.Department of Obstetrics and Gynecology, Ulsan University HospitalUniversity of Ulsan College of MedicineUlsanKorea

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