Pierce and push: a simplified method to facilitate laparoscopic myomectomy

Area of Science:

• Gynecology
• Minimally Invasive Surgery

Background:

• Uterine fibroids are common, often requiring surgical intervention like laparoscopic myomectomy (LM).
• Traditional methods for fibroid enucleation in LM utilize instruments like 5 mm claw forceps.
• A novel pierce and push (PP) method employing a stainless steel centimeter probe has been developed.

Purpose of the Study:

• To evaluate the efficacy and safety of the PP method for fibroid enucleation during LM.
• To compare the PP method with the conventional 5 mm claw forceps technique in LM.

Main Methods:

• Retrospective chart review of 90 women undergoing LM for symptomatic uterine fibroids.
• Comparison of LM performed with the PP method versus LM with 5 mm claw forceps.
• Analysis of operative time, tumor separation time, specimen removal time, blood loss, transfusion rates, and hospital stay.

Main Results:

• The PP group demonstrated a significantly shorter tumor separation time (9.7 ± 3.1 min) compared to the claw forceps group (17.1 ± 4.4 min; p < 0.001).
• No significant differences were observed in operative time, hospitalization duration, specimen removal time, blood loss, or transfusion requirements between the two groups.
• Groups were well-matched for key demographic and clinical characteristics.

Conclusions:

• The PP method, utilizing a stainless steel centimeter probe, offers a significant advantage in fibroid separation during LM.
• The PP technique is more effective for fibroid excision in LM compared to 5 mm claw graspers.
• The PP method is a promising alternative for laparoscopic myomectomy procedures.