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CC BY-NC-ND 4.0 · Surg J (N Y) 2020; 06(S 01): S35-S43
DOI: 10.1055/s-0039-3401027
Precision Surgery in Obstetrics and Gynecology
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Laparoscopic Myomectomy

Masaaki Andou
1   Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama-ken, Japan
,
Shiori Yanai
1   Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama-ken, Japan
,
Akira Shirane
1   Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama-ken, Japan
,
Kiyoshi Kanno
1   Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama-ken, Japan
› Author Affiliations
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Publication History

Publication Date:
03 March 2020 (online)

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Abstract

Laparoscopic myomectomy is minimally invasive treatment for patients suffering from fibroids, especially those wishing to maintain their fertility sparing potential. While this surgery requires intensive training in surgical skills such as intracorporeal suturing and specimen extraction, patients can also expect less adhesion and a quick return to normal activity. This surgery can be broken into three stages, each presenting its own specific and unique challenges—enucleation, reapproximation of the myoma bed, and specimen extraction. To prepare for the broad spectrum of cases where the size and number of fibroids can differ greatly, we have mastered several techniques for each stage of the procedure. To keep the surgery safe, we train for unexpected scenarios by practicing minimally invasive repair and reconstruction techniques. By following basic tenets and understanding the laparoscopic anatomy, we define the targets and boundaries of our dissection to ensure completeness. In this paper, techniques for the enucleation, reapproximation, and extraction will be presented in detail.

Keywords

laparoscopy - myomectomy - less adhesion - intracorporeal suturing - specimen extraction - fibroids