Related Experiment Video
Updated: May 27, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Uterine artery embolization immediately preceding laparoscopic myomectomy
Kara N Goldman1, Jennifer E Hirshfeld-Cytron, Mary-Ellen Pavone
1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Performing uterine artery embolization (UAE) before laparoscopic myomectomy helps minimally invasive surgery for larger fibroids. This combined approach facilitated surgery for larger uteri and myomas without increasing operative time or blood loss.
Area of Science:
- Gynecology
- Minimally Invasive Surgery
- Interventional Radiology
Background:
- Uterine fibroids are common, often requiring surgical intervention.
- Laparoscopic myomectomy is a minimally invasive option, but challenges exist for larger fibroids.
- Uterine artery embolization (UAE) is an established treatment for symptomatic fibroids.
Purpose of the Study:
- To evaluate if performing UAE immediately before laparoscopic myomectomy facilitates minimally invasive surgery for larger uterine fibroids.
- To assess the impact of preoperative UAE on surgical outcomes in laparoscopic myomectomy.
Main Methods:
- Retrospective case-control study analyzing 26 laparoscopic myomectomies.
- Comparison between patients who underwent myomectomy with preoperative UAE and those who had myomectomy alone.
- Matched controls based on age, year, surgeon, and fibroid count.
- Outcomes assessed: uterine size, operative time, blood loss, specimen weight.
Main Results:
- The UAE group had significantly larger uteri (19.7 vs 12.4 weeks) and myoma weights (595.3 vs 153.6 grams).
- No significant differences were observed in operative time or blood loss between the groups.
- No intra-operative complications were reported in either group.
Conclusions:
- Preoperative UAE immediately preceding laparoscopic myomectomy enables minimally invasive surgical treatment for larger uteri and fibroids.
- This combined approach does not compromise operative time or blood loss.
- UAE is a valuable adjunct to facilitate laparoscopic myomectomy in cases of significant fibroid burden.
