title: Laparoscopic-assisted vaginal myomectomy through an anterior approach.
abstract: BACKGROUND
  To evaluate the safety and efficacy of a combined laparoscopic and vaginal approach through the anterior cul-de-sac in dealing with fundal and/or anterior wall uterine myomata.
  
  
  METHODS
  Seven women with symptomatic fundal and/or anterior wall uterine myomata were enrolled in this study. After laparoscopic identification of the location of the myomata, a guiding suture brought the dominant myoma down through the anterior cul-de-sac into the vagina via an anterior colpotomy. Resection and suturing were then performed transvaginally.
  
  
  RESULTS
  Mean +/- standard deviation (SD) operative time, blood loss, and the length of hospital stay were 88.1 +/- 27.8 minutes, 278.6 +/- 131.8 mL, and 2.9 +/- 0.7 days, respectively. No patients developed serious complications, and only four transient macroscopic hematuria occurred intra- and postoperatively.
  
  
  CONCLUSIONS
  Although transient hematuria may occur, a combined laparoscopy and vaginal approach in dealing with fundal and/or anterior wall uterine fibroids through the anterior cul-de-sac is an alternative to pure laparoscopic myomectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Endoscopy, Chang Gung Memorial Hospital, Linkou Medical Center, Tao-Yuan, Taiwan.
authors.forename: Hung-Yen
authors.initials: HY
authors.lastname: Chin
authors.forename: Chyi-Long
authors.initials: CL
authors.lastname: Lee
authors.forename: Chih-Feng
authors.initials: CF
authors.lastname: Yen
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Wang
authors.forename: Yung-Kuei
authors.initials: YK
authors.lastname: Soong
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000601:surgery*; D014621:Vagina