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Tips and tricks: How to control bleeding in mini invasive myomectomy?
Mathilde Castel1, Gaby Moawad2, Malik Boukerrou3
1Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, BP 350, 97448, Saint-Pierre Cedex, La Réunion, France.
Journal of Gynecology Obstetrics and Human Reproduction
|September 28, 2025
Summary
This study presents a reproducible robotic-assisted myomectomy technique for controlling bleeding during minimally invasive surgery. The method effectively manages blood loss in patients desiring future pregnancy.
Area of Science:
- Gynecology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic myomectomy offers benefits like smaller scars and faster recovery.
- Effective bleeding control remains a challenge in minimally invasive myomectomy procedures.
Purpose of the Study:
- To demonstrate a reproducible technique for controlling bleeding during robotic-assisted myomectomy.
- To address the challenge of intraoperative hemorrhage in uterine fibroid removal.
Main Methods:
- A 35-year-old woman with a large fibroid underwent robotic-assisted myomectomy using the Da Vinci Surgical System.
- Techniques included uterine artery occlusion (vascular clamp or metallic clip), subserosal infiltration with xylocaine and epinephrine, and barbed suture closure.
Main Results:
- The described techniques facilitated effective bleeding control during the procedure.
- Postoperative blood loss was less than 200 mL.
Conclusions:
- Robotic-assisted myomectomy with specific bleeding control strategies is a viable option for patients with uterine fibroids.
- This approach is particularly suitable for women desiring future pregnancy, minimizing surgical risks.
