Laparoscopic Surgery for Focal Adenomyosis

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Reproductive Medicine
• Surgical Oncology

Background:

• Laparoscopic adenomyomectomy is increasingly used for conservative treatment of focal uterine adenomyosis.
• Reassessment of safety and efficacy is needed for this minimally invasive approach.
• Reproducibility of laparoscopic adenomyomectomy requires further evaluation.

Purpose of the Study:

• To evaluate the clinical outcomes of laparoscopic adenomyomectomy with transient occlusion of uterine arteries (TOUA).
• To assess the safety and efficacy of this technique for focal uterine adenomyosis.
• To determine the reproducibility of the procedure performed by a single surgeon.

Main Methods:

• A cohort of 105 patients with symptomatic focal uterine adenomyosis underwent laparoscopic adenomyomectomy with TOUA.
• Surgical outcomes including operative time, blood loss, and intraoperative injuries were recorded.
• Symptom improvement (dysmenorrhea, menorrhagia) and lesion recurrence were assessed via ultrasonography and clinical follow-up.

Main Results:

• Mean operative time was 75.14 minutes with mean blood loss of 148.19 mL.
• No major complications or conversion to laparotomy occurred.
• Complete remission of dysmenorrhea (93.02%) and significant improvement in menorrhagia (76.92%) were observed at 7-month follow-up.

Conclusions:

• Laparoscopic adenomyomectomy with TOUA is a safe and effective fertility-sparing surgical option.
• The procedure demonstrates high efficacy in alleviating symptoms of focal uterine adenomyosis.
• This technique is reproducible and suitable for women desiring future fertility.