A new laparoscopic myomectomy technique for intramural fibroids penetrating the uterine cavity.
OBJECTIVE
To evaluate laparoscopic removal of intramural leiomyomata uteri penetrating the uterine cavity, with compression of the uterine isthmic vessels, repair of the endometrial defect, and reconstruction of the myometrium in three layers.


METHODS
32 selected patients with penetrating intramural leiomyomata uteri were subjected to a new laparoscopic myomectomy technique. Conversion from laparoscopy to laparotomy, feasibility and safety of surgical technique, length of operation, hemoglobin loss, intra- and postoperative complications, and length of stay in hospital were evaluated.


RESULTS
All laparoscopic myomectomy attempts were completed laparoscopically without blood transfusion. The operative time ranged from 127 min to 246 min, (mean 163 min). The mean hemoglobin fall was 0.74 g/ml and no intraoperative nor postoperative complication was observed. The average postoperative hospital stay was 7.5 h.


CONCLUSIONS
This operation is safe, shows good reconstructive outcome, and offers an alternative approach to laparotomy, with all advantages of major surgery being executed through minimal access.
Ostrzenski
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Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington DC, USA.
D000328:Adult; D004717:Endometrium / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D018231:Leiomyomatosis / Q000601:surgery*; D008875:Middle Aged; D009215:Myometrium / Q000601:surgery; D011446:Prospective Studies; D012449:Safety; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000601:surgery*