[Clinical study of gasless abdominal-wall lifting laparoscopic myomectomy with 5 mm laparoscope]

To explore the feasibility, advantages and clinical value of gasless abdominal-wall lifting laparoscopic myomectomy with 5 mm laparoscope and 2 abdominal holes (1.5-hole-gasless-laparoscopic myomectomy).

A total of 90 cases of uterine fibroids were randomly divided into 2 groups. Lifting gasless group (n = 46) underwent gasless abdominal-wall lifting laparoscopic myomectomy with 5 mm laparoscope and 2 abdominal holes, and pneumoperitoneum group (n = 44) pneumoperitoneum laparoscopic myomectomy. The operative duration, blood loss volume, average time of single-myoma-removal, intestinal function recovery and hospital stay of both groups were compared.

The operative duration, blood loss volume and average time of single-myoma-removal of lifting gasless group were respectively significantly less than those of pneumoperitoneum group (P < 0.01) . The postoperative intestinal function recovery and postoperative hospital stay had no significant difference between two groups (P > 0.05). Three cases of pneumoperitoneum group were converted successfully into myomectomy with traditional 3-hole gasless abdominal wall lifting laparoscopy because of large fibroids in uterine isthmus. A total of 12 newly discovered myomas, not pre-detected ultrasonically, were removed in 10 cases of lifting gasless group.

1.5-hole-gasless-laparoscopic myomectomy, like traditional gasless laparoscopy, may avoid the complications of laparoscopic CO2 pneumoperitoneum. The smaller laparoscope-hole and sole operating hole make this maneuver a safe, easy and mini-invasive procedure. It is more suitable for clinical application and popularity in primary care.