Multimedia article. Highly effective method for myoma excision and suturing in laparoscopic myomectomy

Area of Science:

• Minimally Invasive Surgery
• Gynecologic Oncology
• Surgical Techniques

Background:

• Laparoscopic myomectomy is preferred over abdominal myomectomy for uterine fibroids.
• Key challenges in laparoscopic myomectomy include myoma excision and uterine defect suturing.
• Experienced surgeons find these steps difficult.

Purpose of the Study:

• To introduce a novel, simple, and effective technique for laparoscopic myomectomy.
• To address the challenges of myoma excision and suturing during laparoscopic myomectomy.
• To utilize standard surgical instrumentation for improved outcomes.

Main Methods:

• The technique involves precise myoma pseudocapsule separation using a dissector and scissors.
• Myoma enucleation is followed by creating a U-shaped suture hole with forceps.
• An interlocking suture is employed, with the assistant maintaining stitch tension during repair.

Main Results:

• 43 patients underwent laparoscopic myomectomy using the described technique.
• Mean operative time was 75.9 minutes, with a mean hospital stay of 2.7 days.
• No conversions to laparotomy or major complications were reported during a 5.9-month follow-up.

Conclusions:

• Laparoscopic myomectomy is feasible and effective using this forceps insertion and continuous interlocking suture technique.
• Standard instruments facilitate easy and efficient execution of the procedure.
• The technique offers a valuable solution for challenging aspects of laparoscopic myomectomy.