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Determination of Whole Blood Loss From Minimally Invasive Myomectomy Using a Standardized Formula: A Pilot Study
Marisa Gigg1, Kathryn Goldrath1, Alexandra Havard1
1Department of OB/GYN, David Geffen School of Medicine at UCLA, Los Angeles, California (Drs. Gigg, Goldrath, Havard, Parvataneni, Mehta, Chiang, Rodriguez, Fahey).
Journal of Minimally Invasive Gynecology
|March 4, 2024
Summary
Median calculated perioperative blood loss (PBL) during minimally invasive surgical myomectomy exceeded intraoperative estimates. Continuous blood loss after myometrial closure suggests EBL underestimates total PBL.
Area of Science:
- Gynecology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Minimally invasive surgical (MIS) myomectomy is a common procedure for uterine fibroids.
- Accurate assessment of blood loss is crucial for patient safety and surgical technique evaluation.
Purpose of the Study:
- To determine the median perioperative blood loss (PBL) during minimally invasive surgical (MIS) myomectomy.
- To compare calculated PBL with intraoperative estimated blood loss (EBL).
Main Methods:
- Prospective pilot study involving 31 patients undergoing laparoscopic or robotic myomectomy.
- Perioperative blood loss (PBL) was calculated using preoperative and postoperative complete blood counts (CBCs).
- Intraoperative estimated blood loss (EBL) was recorded by the surgeon.
Main Results:
- Median calculated PBL (536.3 cc) was significantly greater than median intraoperative EBL (200.0 cc).
- Perioperative blood loss ranged from a net gain of 191.5 cc to a net loss of 2362.5 cc.
- Five patients (16.1%) required conversion to laparotomy, and two patients (6.5%) needed blood transfusions.
Conclusions:
- Intraoperative EBL underestimates total perioperative blood loss in MIS myomectomy.
- Continued blood loss occurs after myometrial bed closure, necessitating evaluation of blood loss both during and after surgery.
- Accurate PBL assessment is vital for understanding surgical outcomes in myomectomy procedures.
