Skip to main content
SpringerLink
Log in

Prediction of operation time for laparoscopic myomectomy by ultrasound measurements

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

This study aimed to develop a regression-based prediction equation for operation time for laparoscopic myomectomy (LM) using ultrasound measurement.

Methods

Patients who were to undergo laparoscopic myomectomy from March 2003 to December 2005 were enrolled prospectively in a tertiary institution. Ultrasound was performed before operation. The myoma weights were calculated and converted into mass units (g) by an assumed smooth muscle density of 1.04 g/cm3. Myomas were weighed immediately after operation, and the correlation between these two weights was assessed by linear regression and limits of agreement. A multivariate linear regression model was fitted to the ultrasound parameters and clinical variables to predict operation time.

Results

Of 109 patients, 203 myomas were removed laparoscopically with a mean ultrasound-measured myoma weight of 137.9 (100.7) g, a diameter of the dominant myoma of 6.30 (1.92) cm, and an operation time of 125 (41) min. Strong correlations were observed between the ultrasound-measured and operated myoma weights. A predictive model, in which operation time = 0.14 × ultrasound-measured myoma weight + 1.68 × BMI + 5.21 × operated myoma number + 0.06 × (ultrasound-measured myoma weight × operated myoma number) + 43.97, was developed.

Conclusions

Operation time was significantly related to the myoma weight measured by ultrasound. The ultrasound-derived prediction equation is valid and reliable in predicting operation time for LM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.

Similar content being viewed by others

References

  1. Bland JM, Altman DG (2003) Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 22: 85–93

    Article  PubMed  CAS  Google Scholar 

  2. Cantuaria GH, Angioli R, Frost L, Duncan R, Penalver MA (1998) Comparison of bimanual examination with ultrasound examination before hysterectomy for uterine leiomyoma. Obstet Gynecol 92: 109–112

    Article  PubMed  CAS  Google Scholar 

  3. Chang WC, Torng PL, Huang SC, Sheu BC, Hsu WC, Chen RJ,Chow SN, Chang DY (2005) Laparoscopic-assisted vaginal hysterectomy with uterine artery ligation through retrograde umbilical ligament tracking. J Minim Invasive Gynecol 12: 336–342

    Article  PubMed  Google Scholar 

  4. Dubuisson JB, Lecuru F, Foulot H, Mandelbrot L, Aubriot FX, Mouly M (1991) Myomectomy by laparoscopy: a preliminary report of 43 cases. Fertil Steril 56: 827–830

    PubMed  CAS  Google Scholar 

  5. Dubuisson JB, Chavet X, Chapron C, Gregorakis SS, Morice P (1995) Uterine rupture during pregnancy after laparoscopic myomectomy. Hum Reprod 10: 1475–1477

    PubMed  CAS  Google Scholar 

  6. Dubuisson JB, Chapron C, Levy L (1996) Difficulties and complications of laparoscopic myomectomy. J Gynecol Surg 12: 159–165

    Article  Google Scholar 

  7. Dubuisso JB, Fauconnier A, Babaki-Fard K, Chapron C (2000) Laparoscopic myomectomy: a current view. Hum Reprod Update 6: 588–594

    Article  PubMed  CAS  Google Scholar 

  8. Dubuisson JB, Fauconnier A, Fourchotte V, Babaki-Fard K, Coste J, Chapron C (2001) Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16: 1726–1731

    Article  PubMed  CAS  Google Scholar 

  9. Farquhar C, Brown PM, Furness S (2002) Cost effectiveness of pre-operative gonadotrophin releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy. BJOG 109: 1273–1280

    Article  PubMed  CAS  Google Scholar 

  10. Friedman AT, Haas ST (1993) Should uterine size be an indication for surgical intervention in women with myomas? Am J Obstet Gynecol 168: 751–755

    PubMed  CAS  Google Scholar 

  11. Goldberg J, Pereira L, Berghella V, Diamond J, Darai E, Seinera P, Seracchioli R (2004) Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy. Am J Obstet Gynecol 191: 18–21

    Article  PubMed  Google Scholar 

  12. Harb TS, Adam RA (2005) Predicting uterine weight before hysterectomy: ultrasound measurement versus clinical assessment. Am J Obstet Gynecol 193: 2122–2125

    Article  PubMed  Google Scholar 

  13. Hasson HM, Rotman C, Rana N, Sistos F, Dmowski WP (1992) Laparoscopic myomectomy. Obstet Gynecol 80: 884–888

    PubMed  CAS  Google Scholar 

  14. Kung FT, Chang SY (1996) The relationship between ultrasonic volume and actual weight of pathologic uterus. Gynecol Obstet Invest 42: 35–38

    Article  PubMed  CAS  Google Scholar 

  15. Landi S, Zaccoletti R, Ferrari L, Minelli L (2001) Laparoscopic myomectomy: technique, complications, and ultrasound scan evaluations. J Am Assoc Gynecol Laparosc 8: 231–240

    Article  PubMed  CAS  Google Scholar 

  16. Mais V, Ajossa S, Guerriero S, Mascia M, Solla E, Melis GB (1996) Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol 174: 654–658

    Article  PubMed  CAS  Google Scholar 

  17. Marret H, Chevillot M, Giraudeau B (2004) A retrospective multicentre study comparing myomectomy by laparoscopy and laparotomy in current surgical practice. What are the best patient selection criteria? Eur J Obstet Gynecol Reprod Biol 117: 82–86

    Article  PubMed  Google Scholar 

  18. Marret H, Chevillot M, Giraudeau B, Study Group of the French Society of Gynaecology and Obstetrics (Ouest Division) (2006) Factors influencing laparoconversions during the learning curve of laparoscopic myomectomy. Acta Obstet Gynecol Scand 85: 324–329

    Article  PubMed  CAS  Google Scholar 

  19. Murase E, Siegelman ES, Outwater EK, Perez-Jaffe LA, Tureck RW (1999) Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics 9: 1179–1197

    Google Scholar 

  20. Nezhat C, Nezhat F, Silfen SL, Schaffer N, Evans D (1991) Laparoscopic myomectomy. Int J Fertil 36: 275–280

    PubMed  CAS  Google Scholar 

  21. Papp Z, Sztanyik L, Szabo I, Inovay J (1996) Successful pregnancy after bilateral internal iliac artery ligation monitored by color Doppler imaging. Ultrasound Obstet Gynecol 7: 211–212

    Article  PubMed  CAS  Google Scholar 

  22. Parker WH, Rodi IA (1994) Patient selection for laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 2: 23–26

    Article  PubMed  CAS  Google Scholar 

  23. Platt JF, Bree RL, Davidson D (1990) Ultrasound of the normal nongravid uterus: correlation with gross and histopathology. J Clin Ultrasound 18: 15–19

    Article  PubMed  CAS  Google Scholar 

  24. Seinera P, Arisio R, Decko A, Farina C, Crana F (1997) Laparoscopic myomectomy: indications, surgical technique and complications. Hum Reprod 12: 1927–1930

    Article  PubMed  CAS  Google Scholar 

  25. Semm K, Mettler L (1980) Technical progress in pelvic surgery via operative laparoscopy. Am J Obstet Gynecol 138: 121–127

    PubMed  CAS  Google Scholar 

  26. Shimanuki H, Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kinoshita K (2006) The effect of vasopressin on local and general circulation during laparoscopic surgery. J Minim Invasive Gynecol 13: 190–194

    Article  PubMed  Google Scholar 

  27. Sinha R, Hegde A, Warty N, Patil N (2003) Laparoscopic excision of very large myomas. J Am Assoc Gynecol Laparosc 10: 461–468

    Article  PubMed  Google Scholar 

  28. Sinha RY, Hegde A, Warty N, Jain R (2004) Laparoscopic devascularization of uterine myomata followed by enucleation of the myomas by direct morcellation. J Am Assoc Gynecol Laparosc 11: 99–102

    Article  PubMed  Google Scholar 

  29. Stewart EA (2001) Uterine fibroids. Lancet 357: 293–298

    Article  PubMed  CAS  Google Scholar 

  30. Torng PL, Chang WC, Hwang JS, Hsu WC, Wang JD, Huang SC, Chen CF, Su TC (2007) Quality of life after laparoscopically-assisted vaginal hysterectomy: is uterine weight a major factor? Qual Life Res 16:227–237

    Article  PubMed  Google Scholar 

  31. Vessey MP, Villard-Mackintosh L, McPherson K, Coulter A, Yeates D (1992) The epidemiology of hysterectomy: findings in a large cohort study. Br J Obstet Gynaecol 99: 402–407

    PubMed  CAS  Google Scholar 

  32. Wagaarachchi PT, Fernando L (2000) Fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage: case report. Hum Reprod 15: 1311–1313

    Article  PubMed  CAS  Google Scholar 

  33. Zullo F, Pellicano M, De Stefano R, Zupi E, Mastrantonio P (1998) A prospective randomized study to evaluate leuprolide acetate treatment before laparoscopic myomectomy: efficacy and ultrasonographic predictors. Am J Obstet Gynecol 178: 108–112

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by grant NTUH095-000400 from National Taiwan University Hospital.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

    Wen-Chiung Hsu, Wen-Chun Chang, Su-Cheng Huang, Bor-Ching Sheu & Pao-Ling Torng

  2. Department of Obstetrics and Gynecology, Buddhist Tzu-Chi General Hospital, Buddhist Tzu-Chi College of Medicine, Taipei, Taiwan

    Wen-Chiung Hsu

  3. Institute of Statistical Science, Academia Sinica, Taipei, Taiwan

    Jing-Shiang Hwang

Authors
  1. Wen-Chiung Hsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jing-Shiang Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wen-Chun Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Su-Cheng Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bor-Ching Sheu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pao-Ling Torng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pao-Ling Torng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hsu, WC., Hwang, JS., Chang, WC. et al. Prediction of operation time for laparoscopic myomectomy by ultrasound measurements. Surg Endosc 21, 1600–1606 (2007). https://doi.org/10.1007/s00464-006-9189-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-006-9189-1

Keywords

Search

Navigation