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Surgery results using different uterine wall incision directions in laparoscopic myomectomy of the intramural myoma

  • Original Article
  • Surgery
  • Published:
Reproductive Medicine and Biology

Abstract

Objective

To study clinical outcomes for different uterine wall incision directions, comparing vertical incision and transverse incision in laparoscopic myomectomy of the intramural myoma.

Methods

Laparoscopic myomectomies were performed on 50 women with intramural myomas. Using a table of random numbers, they were randomly divided into a vertical incision group (25 women) and a transverse incision group (25 women) according to the direction of incisions in the uterine wall. The numbers of enucleated myoma, operation duration, amount of bleeding, and numbers of sutures were compared. The Mann-WhitneyU-test was used for analysis.

Results

For the transverse incision group, the amount of bleeding (137.6 ± 88.1 mL) was a significantly lower value (P = 0.0426) than for the vertical incision group (235.8 ± 169.4 mL). In addition, in cases where the maximum myoma nucleus diameter was 7 cm or larger, operation duration (129.0 ± 32.5 min) and amount of bleeding (158.9 ± 87.1 mL) showed significantly lower values (P = 0.0067 andP = 0.0002, respectively) for the transverse incision group than did operation duration (362.3 ± 147.3 min) and amount of bleeding (362.3 ± 147.3 mL) for the vertical incision group.

Conclusion

Transverse incision of the uterine wall is useful to reduce the amount of bleeding in the laparoscopic myomectomy of the intramural myoma. Transverse incision also shortens operation duration in cases where the myoma nuclei are large.

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References

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

    PubMed  CAS  Google Scholar 

  2. Gordon AG, Magos AL. The development of laparoscopic surgery.Baillieres Clin Obstet Gynaecol 1989;3: 429–449.

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  5. Mais V, Ajossa S, Guerriero S, Mascia M, Solla E, Melis GB. Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome.Am J Obstet Gynecol 1996;175: 654–658.

    Article  Google Scholar 

  6. Verkauf BS. Myomectomy for fertility enhancement and preservation.Fenil Steril 1992;58: 1–15.

    CAS  Google Scholar 

  7. Wallach EE. Myomectomy. In: Thompson JD, Rock JA, (eds).Te Linde’s Operative Gynecology, 7th edn. Philadelphia: JB Lippincott, 1992; 647–662.

    Google Scholar 

  8. Igarashi M. Value of myomectomy in the treatment of infertility.Fertil Steril 1993;59: 1331–1332.

    PubMed  CAS  Google Scholar 

  9. Sampson JA. The influence of myomata on the blood supply of the uterus, with special reference to abdominal uterine bleeding.Surg Gynecol Obstet 1913;16: 144–180.

    Google Scholar 

  10. Faulkner RL. An injection study of uterine blood vessels.Am ) Obstet Gynecol 1945;49: 1–9.

    Google Scholar 

  11. Farrer-Brown G, Beilby JO, Tarbit MH. The blood supply of the uterus. 1. Arterial vasculature.J Obstet Gynaecol Br Commonw 1970;77: 673–681.

    PubMed  CAS  Google Scholar 

  12. Farrer-Brown G, Beilby JO, Tarbit MH. The blood supply of the uterus. 2. Venous pattern.J Obstet Gynaecol Br Commonw 1970;77: 682–689.

    PubMed  CAS  Google Scholar 

  13. Farrer-Brown G, Beilby JO, Tarbit MH. The vascular patterns in myomatous uteri.J Obstet Gynaecol Br Commonw 1970;77: 967–975.

    PubMed  CAS  Google Scholar 

Download references

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Correspondence to Mineto Morita.

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Morita, M., Asakawa, Y., Uchiide, I. et al. Surgery results using different uterine wall incision directions in laparoscopic myomectomy of the intramural myoma. Reprod Med Biol 3, 33–37 (2004). https://doi.org/10.1111/j.1447-0578.2004.00049.x

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  • DOI: https://doi.org/10.1111/j.1447-0578.2004.00049.x

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