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Hand-assisted laparoscopy for megamyomectomy. A case report.
M A Pelosi1, M A Pelosi, J Eim
1Pelosi Women's Medical Center, Bayonne, NJ 07002, USA.
The Journal of Reproductive Medicine
|July 20, 2000
Summary
Hand-assisted laparoscopy offers a safe, minimally invasive alternative for removing massive uterine fibroids when conventional laparoscopic surgery is not feasible. This approach allows for effective myomectomy, potentially replacing traditional open surgery for suitable patients.
Area of Science:
- Minimally Invasive Surgery
- Gynecologic Oncology
- Surgical Innovation
Background:
- Traditional laparotomy is often necessary for massive uterine myomas.
- Conventional laparoscopic myomectomy is not feasible for very large fibroids.
- Hand-assisted laparoscopy (HAL) presents a novel minimally invasive alternative.
Observation:
- A case report details HAL for a 28-year-old nullipara with a massive uterus (3,120g fibroids) extending to the liver.
- The procedure utilized a 7.5-cm suprapubic incision and a 1-cm umbilical port, preserving pneumoperitoneum.
- Surgery was completed in 120 minutes with 250 mL blood loss.
Findings:
- Hand-assisted laparoscopic myomectomy was successfully performed.
- The patient experienced an uneventful recovery and was discharged on postoperative day 2.
- This demonstrates the feasibility and safety of HAL for massive myomas.
Implications:
- HAL may replace laparotomy for patients with massive uterine fibroids unsuitable for conventional laparoscopy.
- This technique expands minimally invasive options in gynecologic surgery.
- Further studies are warranted to confirm the broad applicability of HAL in managing large uterine myomas.