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Laparoscopic-assisted vaginal myomectomy through an anterior approach
Hung-Yen Chin1, Chyi-Long Lee, Chih-Feng Yen
1Department of Obstetrics and Gynecology, Division of Gynecologic Endoscopy, Chang Gung Memorial Hospital, Linkou Medical Center, Tao-Yuan, Taiwan.
Background:
To evaluate the safety and efficacy of a combined laparoscopic and vaginal approach through the anterior cul-de-sac in dealing with fundal and/or anterior wall uterine myomata.
Patients And Methods:
Seven women with symptomatic fundal and/or anterior wall uterine myomata were enrolled in this study. After laparoscopic identification of the location of the myomata, a guiding suture brought the dominant myoma down through the anterior cul-de-sac into the vagina via an anterior colpotomy. Resection and suturing were then performed transvaginally.
Results:
Mean +/- standard deviation (SD) operative time, blood loss, and the length of hospital stay were 88.1 +/- 27.8 minutes, 278.6 +/- 131.8 mL, and 2.9 +/- 0.7 days, respectively. No patients developed serious complications, and only four transient macroscopic hematuria occurred intra- and postoperatively.
Conclusion:
Although transient hematuria may occur, a combined laparoscopy and vaginal approach in dealing with fundal and/or anterior wall uterine fibroids through the anterior cul-de-sac is an alternative to pure laparoscopic myomectomy.
