title: Safe techniques in surgery for hysteroscopic myomectomy.
abstract: Hysteroscopic myomectomy is regarded as the best treatment for patients with submucous myomata. However, this procedure has a number of associated complications, including uterine perforation, cervical laceration, hyponatremia and hemorrhage, especially in cases of sessile submucous myomata. To avoid these problems, it is important to make well-advised preparations and manipulations both pre- and intraoperatively. The main surgical considerations for safe hysteroscopic myomectomy are shortening the operating time and avoiding cutting too deeply into the myometrium. With these requirements in mind, a combination of techniques using vaporization and a powerful oxytocic agent, such as prostaglandin F-2alpha, appears to be the safest method of carrying out hysteroresectoscopy for unpedunculated sessile submucous myomata.
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan. tm@ob-gyn.tohoku.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Tamura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Ozawa
authors.forename: Haruka
authors.initials: H
authors.lastname: Suzuki
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Terada
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Okamura
mesh_terms: D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D011183:Postoperative Complications; D014594:Uterine Neoplasms / Q000601:surgery*