Laparoscopic myomectomy with aquadissection and barbed sutures

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Myomectomy, the surgical removal of uterine fibroids, can be associated with significant blood loss.
• Effective hemostasis and clear surgical fields are crucial for successful myomectomy outcomes.
• Novel techniques are sought to improve the safety and efficiency of myomectomy procedures.

Purpose of the Study:

• To evaluate the efficacy of the aquadissection technique in minimizing blood loss during myomectomy.
• To assess the benefits and feasibility of utilizing barbed sutures for myometrial defect closure post-myomectomy.

Main Methods:

• Aquadissection involves injecting a diluted vasopressin-saline solution into the myometrium prior to incision.
• Uterine incision is performed using simple scissors, relying on saline leakage for hemostasis.
• Barbed sutures were employed for the closure of the myometrial defect.

Main Results:

• Aquadissection facilitated a clear surgical field by minimizing bleeding, with saline leakage observed instead of blood loss.
• The technique aided in identifying the correct plane between the fibroid and myometrium, simplifying dissection.
• The use of barbed sutures for closure was found to be feasible.

Conclusions:

• Aquadissection is an effective technique for reducing blood loss in myomectomy.
• This method enhances surgical field clarity and aids in precise fibroid separation.
• Barbed sutures offer a feasible option for myometrial defect closure in myomectomy procedures.