title: Gasless laparoscopically assisted myomectomy using a wound retraction system.
abstract: BACKGROUND
  The purpose of this study was to elucidate the feasibility of gasless laparoscopically assisted myomectomy (LAM) using a wound retraction system. This method treats symptomatic uterine myomas by combining laparoscopy with a mini-laparotomy to enucleate myoma nodules and to close the uterine myometrium.
  
  
  METHODS
  This study includes 275 patients who underwent gasless LAM. For patients with fewer than three myoma nodules, the location of the largest nodule was classified as anterior, fundal, or posterior. The operative outcomes, intraoperative and postoperative courses, and complications were examined.
  
  
  RESULTS
  All operations were performed satisfactorily, and no conversions to laparotomy were required. None of the patients developed serious complications. The mean blood loss and operating time were 190.3 mL and 152.2 minutes, respectively. The mean myoma size was 8.9 cm, and the mean number of myomas per patient was 2.8. The average postoperative hospital stay was 5.7 days. There were no significant differences in resected myoma size, blood loss, and surgical duration with respect to the location of the largest nodule.
  
  
  CONCLUSIONS
  Gasless LAM with a wound retractor is feasible and allows surgeons to perform myomectomy safely and cost-effectively, without requiring advanced laparoscopic surgical skills and while maintaining minimum invasiveness.
authors: Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan. s-akira@nms.ac.jp
authors: S
authors: S
authors: Akira
authors: M
authors: M
authors: Ichikawa
authors: N
authors: N
authors: Iwasaki
authors: N
authors: N
authors: Ouchi
authors: K
authors: K
authors: Mine
authors: A
authors: A
authors: Miura
authors: K
authors: K
authors: Kurose
authors: T
authors: T
authors: Takeshita
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007813:Laparotomy; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D009215:Myometrium / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*