Laparoscopic-assisted vaginal myomectomy through an anterior approach.
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.
Chin
Hung-Yen
HY
Department of Obstetrics and Gynecology, Division of Gynecologic Endoscopy, Chang Gung Memorial Hospital, Linkou Medical Center, Tao-Yuan, Taiwan.
Lee
Chyi-Long
CL
Yen
Chih-Feng
CF
Wang
Chin-Jung
CJ
Soong
Yung-Kuei
YK
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000601:surgery*; D014621:Vagina