Laparoscopic temporary clipping of uterine artery during laparoscopic myomectomy.
OBJECTIVE
Our aim is to study the feasibility and effect of bilateral laparoscopic temporary occlusion of uterine arteries by special vascular clamps on blood loss during laparoscopic myomectomy.


METHODS
Of 166 women with symptomatic uterine myomas necessitating surgical intervention who wished to retain their uteri, 80 underwent laparoscopic uterine artery clipping and myomectomy (experimental group) and 86 received laparoscopic myomectomy only (control group). Main outcome measures were operating time, number and weight of leiomyomas, blood loss, Doppler examination of the uterine arteries and complications of procedure.


RESULTS
In the experimental group the median hemoglobin drop measured on day 3 postoperatively was 1.2 g/dl. In the control group the mean hemoglobin drop measured on day 3 postoperatively was 1.45 g/dl. The time needed to put the clips in place (the time from the opening of the retroperitoneum and the positioning of the clips) varied between 6 and 40 min. No patient required blood transfusion. There were no conspicuous complications.


CONCLUSIONS
The use of the clips has proved to be statistically effective in reducing hemoglobin loss during laparoscopic myomectomy.
Department of Gynecology, Charité Universitätsmedizin, Berlin, Germany. enonloso1@hotmail.com
Giuseppe
G
Vercellino
Evrim
E
Erdemoglu
Aries
A
Joe
Werner
W
Hopfenmueller
Bernd
B
Holthaus
Christhardt
C
Köhler
Achim
A
Schneider
Kati
K
Hasenbein
Vito
V
Chiantera
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001810:Blood Volume; D016009:Chi-Square Distribution; D005260:Female; D006488:Hemostasis, Surgical / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013997:Time Factors; D014463:Ultrasonography; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000601:surgery; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000098:blood supply