title: Isobaric gasless laparoscopic myomectomy for removal of large uterine leiomyomas.
abstract: BACKGROUND
  This study aimed to evaluate the feasibility and safety of isobaric laparoscopic removal of large myomas (> or = 8 cm) using the Laparotenser, a subcutaneous abdominal wall-lifting system.
  
  
  METHODS
  A series of 63 consecutive patients with at least one large symptomatic subserosal or intramural uterine myoma (> or = 8 cm) underwent an isobaric gasless laparoscopic myomectomy. Conventional laparotomy instruments were used.
  
  
  RESULTS
  The procedure was successfully completed for all 63 consecutive patients. The average size of the dominant myoma was 11 cm. The mean number of myomas removed from each patient was 3.6. The mean blood loss was 143 ml, and the mean operating time was 72 min. No intraoperative complication occurred.
  
  
  CONCLUSIONS
  Gasless laparoscopic myomectomy for the removal of large myomas using the Laparotenser is feasible and safe. It offers several advantages over laparoscopy with pneumoperitoneum.
authors.affiliation: Division of Obstetrics and Gynecology, International School of Gynaecological Endoscopy, S. Pio X Hospital, Via F. Nava 31, 20159, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Damiani
authors.forename: L
authors.initials: L
authors.lastname: Melgrati
authors.forename: G
authors.initials: G
authors.lastname: Franzoni
authors.forename: M
authors.initials: M
authors.lastname: Stepanyan
authors.forename: S
authors.initials: S
authors.lastname: Bonifacio
authors.forename: F
authors.initials: F
authors.lastname: Sesti
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D018231:Leiomyomatosis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D013523:Surgical Equipment; D013997:Time Factors; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*