Laparoscopic adenomyomectomy and hysteroplasty: a novel method.
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.
Takeuchi
Hiroyuki
H
Department of Obstetrics and Gynecology, Department of Pathology, Juntendo University School of Medicine, Tokyo, Japan. hirotake@med.juntendo.ac.jp
Kitade
Mari
M
Kikuchi
Iwaho
I
Shimanuki
Hiroto
H
Kumakiri
Jun
J
Kitano
Takamitsu
T
Kinoshita
Katsuyuki
K
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*