Laparoendoscopic single site surgery for cervical myomectomy: surgical technique

Cervical fibroid is a rare type of fibroid which occurs in a special location. Due to the low position, it tends to grow into the broad ligament or even extend into the pelvic floor, compressing the ureter or uterine artery. Surgical treatments for cervical myoma are divided into three categories: open transabdominal cervical myomectomy, laparoscopic cervical myomectomy, and transvaginal cervical myomectomy. Among these, laparoscopic cervical myomectomy is the most common. Traditional multiport laparoscopy (MPL) often encounters difficulties in specimen retrieval after cervical myomectomy, frequently requiring the use of specimen bags and morcellators, which may lead to tumor cell dissemination. In contrast, after laparoendoscopic single site surgery (LESS) via the umbilicus, the specimen can be extracted through the umbilical incision using a specimen bag, effectively adhering to the principle of tumor-free surgery. However, the "chopstick effect" in LESS increases surgical difficulty and the risk of ureteral injury. This educational surgical video primarily introduces the surgical techniques and management of a cervical fibroid treated with LESS myomectomy via the umbilicus. The patient was a 28-year-old woman, preoperatively diagnosed with broad ligament fibroid. Intraoperatively, the condition was identified as cervical fibroid with a size of 10 cm × 7 cm × 6 cm, and a single-port laparoscopic resection of the cervical fibroid was performed. The surgery lasted 73 minutes with 20 mL of blood loss. The pathology report indicated leiomyoma. The patient was discharged three days postoperatively without severe complications.