Minimally invasive management of uterine fibroids.
OBJECTIVE
Many minimally invasive techniques have recently been introduced for the management of uterine fibroids. The purpose of this review is to analyse recent data for techniques that are used to manage uterine fibroids.


RESULTS
Laparoscopic myomectomy has provided a minimally invasive alternative to laparotomy for intramural and subserous myomata. However, this technique is still the subject of debate. With good surgical experience, the risk of perioperative complications is comparable with conventional surgery. Laparoscopic myomectomy is associated with faster postoperative recovery, and could potentially reduce the risk of postoperative adhesions compared with laparotomy. Spontaneous uterine rupture, although uncommon after laparoscopic myomectomy, is still a concern. The risk of recurrence seems to be higher after laparoscopic myomectomy than after myomectomy performed by laparotomy. Uterine artery embolization is another new and attractive treatment for patients with symptomatic fibroids. Uterine artery embolization provides excellent relief for abnormal bleeding, pelvic pain, and bulk-related symptoms. Early reports show that uterine artery embolization is associated with normal reproductive and obstetric functions. This technique is associated with a shorter hospital stay and a rapid recovery time.


CONCLUSIONS
Laparoscopic myomectomy and uterine artery embolization are being performed more than ever. Current evidence proves the safety, reliability and reproducibility of both procedures. However, prospective randomized controlled trials comparing both procedures with conventional myomectomy are needed.
Falcone
Tommaso
T
Department of Gynecology and Obstetrics, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. falcont@ccf.org
Bedaiwy
Mohamed A
MA
D002986:Clinical Trials as Topic; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009215:Myometrium / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D016896:Treatment Outcome; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000628:therapy; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014599:Uterus / Q000098:blood supply