title: Laparoscopic adenomyomectomy and hysteroplasty: a novel method.
abstract: OBJECTIVE
  To evaluate a novel method of laparoscopic adenomyomectomy.
  
  
  METHODS
  Prospective study (Canadian Task Force classification II-3).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Fourteen women with adenomyosis.
  
  
  METHODS
  Laparoscopic adenomyomectomy and hysteroplasty. After local injection by diluted vasopressin solution, a transverse incision was made in the adenomyotic tissue down to the endometrium, and the adenomyotic tissue was surgically removed with a monopolar needle. The normal muscle layer on the serosal membrane side was left as an upper and lower serosal flap. The flaps were overlapped and sutured to counteract the lost muscle layer to reconstruct the uterus. MEASUREMENTS AND MAIN OUTCOME: The changes of symptoms were evaluated before and after the operation. The visual analog scale of dysmenorrhea was significantly decreased, and hypermenorrhea was improved after the surgery. Postoperative pregnancy was achieved in 2 patients, and vaginal delivery was performed in the first case.
  
  
  CONCLUSIONS
  For specific cases, laparoscopic adenomyomectomy may be a suitable method to relieve symptoms with minimally invasive surgery while conserving the uteri.
authors.affiliation: Department of Obstetrics and Gynecology, Department of Pathology, Juntendo University School of Medicine, Tokyo, Japan. hirotake@med.juntendo.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Mari
authors.initials: M
authors.lastname: Kitade
authors.forename: Iwaho
authors.initials: I
authors.lastname: Kikuchi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Shimanuki
authors.forename: Jun
authors.initials: J
authors.lastname: Kumakiri
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Kitano
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000175:diagnosis / Q000601:surgery*