Surgical Endoscopy

, Volume 33, Issue 7, pp 2114–2120 | Cite as

Temporary simultaneous two-arterial occlusion for reducing operative blood loss during laparoscopic myomectomy: a randomized controlled trial

  • Hwa Cheong Kim
  • Taejong SongEmail author



To evaluate the efficacy and safety of temporary simultaneous two-arterial occlusions (TESTO) in terms of operative blood loss during laparoscopic myomectomy.


A total of 62 patients with symptomatic myomas were randomly assigned to either the experimental group or the control group. In the experimental group, the uterine arteries and utero-ovarian arteries were temporarily occluded with laparoscopic bulldog clamps. The primary outcome measures were operative blood loss and change in hemoglobin.


There were no differences in baseline demographics between the two groups. The amounts of operative blood loss (56.3 ± 42.8 mL vs. 138.2 ± 48.8 mL, p < 0.001) and change in hemoglobin (1.0 ± 0.5 g/dL vs. 1.7 ± 1.1 g/dL, p = 0.002) were significantly lower in the experimental group than that in the control group. The total operative time was not significantly different between the two groups. However, it took less time for myoma enucleation (13.1 ± 14.6 min vs. 17.6 ± 10.4 min, p = 0.006) and for uterine suturing (19.5 ± 10.7 min vs. 24.6 ± 8.8 min, p = 0.006) in the experimental group than that in the control group. None of patients in both groups developed operative complications.


The use of the TESTO procedure is effective in reducing operative blood loss and hemoglobin loss without causing morbidity during laparoscopic myomectomy.


Myomectomy Myoma Bulldog clamp Operative blood loss Laparoscopic myomectomy 


Compliance with ethical standards


Drs. Hwa Cheong Kim and Taejong Song have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 193117 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea

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