Laparoscopic excision of very large myomas.
OBJECTIVE
To evaluate the feasibility, complications, and conversion rate of laparoscopic excision of very large myomas.


METHODS
Prospective study (Canadian Task Force classification II-2).


METHODS
Private endoscopy center.


METHODS
Fifty-one women with at least one myoma larger than 9 cm.


METHODS
Laparoscopic myomectomy.


RESULTS
We removed 78 myomas laparoscopically in these 51 patients. Three patients had two myomas larger than 9 cm, three had two myomas between 5 and 9 cm (in addition to 1 > 9 cm), and one had three myomas between 5 and 9 cm (in addition to 1 > 9 cm). Mean number of myomas removed/patient was 1.53 +/- 1.17 (range 1-6); 12 women (23.5%) had multiple myomectomy. The largest myoma removed was 21 cm. Mean myoma weight was 698.47 +/- 569.13 g (range 210-3400 g). Mean operating time was 136.67 +/- 38.28 minutes (range 80-270 min). Mean blood loss was 322.16 +/- 328.2 ml (range 100-2000 ml). One patient developed a broad ligament hematoma, two developed postoperative fever, and one underwent open subtotal hysterectomy 9 hours after surgery for dilutional coagulopathy.


CONCLUSIONS
Myomectomy by laparoscopy is a safe alternative to laparotomy for very large myomas.
Sinha
Rakesh
R
Bombay Endoscopic Academy and Centre for Minimally Invasive Surgery Research, Mumbai, India.
Hegde
Aparna
A
Warty
Neeta
N
Patil
Nandita
N
D000328:Adult; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*