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Published on: January 17, 2019
Cold Scissors and Small Myotomy: A Laparoscopic Intracapsular Myomectomy Method for Women in Reproductive Age
Eleni-Markella Chalkia-Prapa1, Andrea Tinelli2, Giovanni Pecorella2
13 Department of Obstetrics and Gynaecology, Ippokrateio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Gynecology and Minimally Invasive Therapy
|June 29, 2026
Summary
The "cold scissors" technique for laparoscopic intracapsular myomectomy offers minimal incisions, reduced bleeding, and faster healing. This approach is a reliable option for women desiring future pregnancies.
Area of Science:
- Minimally Invasive Gynecologic Surgery
- Reproductive Medicine
- Surgical Oncology
Background:
- Uterine fibroids are common, often requiring surgical intervention.
- Intracapsular myomectomy is a surgical technique to remove fibroids while preserving uterine integrity.
- Minimizing surgical trauma is crucial for fertility preservation and recovery.
Purpose of the Study:
- To evaluate the surgical outcomes of the "cold scissors" technique during laparoscopic intracapsular myomectomies.
- To assess the impact of minimal myotomy on uterine incision length and wound healing.
- To determine the feasibility and safety of this technique for women of reproductive age.
Main Methods:
- Prospective observational cohort study (May 2017 - June 2022).
- Inclusion of 112 female patients with intramural fibroids (FIGO 4-6, 4-10 cm diameter).
- Evaluation of initial and final uterine incision lengths, blood loss, and healing duration.
Main Results:
- Mean initial incision: 3.6 cm; final incision: 2.5 cm.
- Average blood loss: 115 mL; healing period: 30-50 days.
- 45 clinical pregnancies, 5 miscarriages; no uterine ruptures or adhesions post-cesarean.
Conclusions:
- The "cold scissors" laparoscopic technique is a reliable and feasible option for intracapsular myomectomy.
- Minimal myometrial incision leads to reduced injury, bleeding, and faster recovery.
- This approach supports fertility preservation and successful postoperative conception.
