title: The indications, surgical techniques, and limitations of laparoscopic myomectomy.
abstract: OBJECTIVE
  To assess the indications and limits of laparoscopic myomectomies (LM).
  
  
  METHODS
  We conducted a retrospective analysis of 89 consecutive cases of LM. Our LM procedures were as follows: Diluted vasopressin was injected into the myoma capsule, and a transverse incision was made by fine monopolar electrode. Traction was applied to the myoma with a myoma screw. The uterine wall was sutured with a curved needle. Fibrin glue spray was applied to prevent adhesion formation. Enucleated myomas were removed via trocar by using an electric morcellator.
  
  
  RESULTS
  We enucleated 195 nodules with diameters > 2 cm; the mean size of the dominant myomas was 5.3 cm. The mean number of myomas removed from each patient was 2. The uterine wall was sutured in all cases with a mean of 9 sutures. The mean blood loss was 102 mL, and the mean operating time was 111 minutes. No patients were converted to laparotomy. The average hospital stay was 2.4 days. When the myomas were larger than 10 cm, the blood loss and operating time were increased. However, the number of myomas did not correlate with blood loss.
  
  
  CONCLUSIONS
  LM appears to offer a number of advantages if the myoma is not larger than 10 cm.
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan. hirotake@med.juntendo.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kuwatsuru
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay; D017697:Premenopause; D012189:Retrospective Studies; D013536:Suture Techniques; D013997:Time Factors; D014594:Uterine Neoplasms / Q000601:surgery*