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Parasitized Leiomyoma Necessitating Segmental Bowel Resection and Laparotomy Conversion: A Challenging Minimally
Carin Carroll1, Jessica Dai1, Laura A Douglass1
1Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois.
Journal of Minimally Invasive Gynecology
|August 1, 2026
Summary
A rare case of uterine fibroids parasitized by bowel required conversion from robotic surgery to laparotomy for bowel resection. This highlights the need for surgical adaptability when encountering unexpected intraoperative findings during myomectomy.
Area of Science:
- Gynecologic Surgery
- Gastrointestinal Surgery
- Surgical Pathology
Background:
- Symptomatic uterine fibroids are common, often treated with myomectomy.
- Robotic-assisted myomectomy offers minimally invasive benefits.
- Intraoperative complications, though rare, can necessitate surgical approach modification.
Purpose of the Study:
- To report a rare case of extensive bowel parasitization of a uterine leiomyoma.
- To illustrate the surgical challenges and management of this uncommon presentation.
- To emphasize the importance of intraoperative adaptability in gynecologic surgery.
Main Methods:
- Case report of a 37-year-old woman.
- Robotic-assisted myomectomy for symptomatic uterine fibroids.
- Intraoperative findings and conversion to laparotomy with bowel resection.
Main Results:
- Extensive bowel parasitization of a large fundal leiomyoma was discovered intraoperatively.
- Dense bowel adherence necessitated conversion to open laparotomy.
- Segmental bowel resection with primary anastomosis was successfully performed.
Conclusions:
- Parasitized uterine leiomyomas present a rare but significant surgical challenge.
- Minimally invasive approaches may require conversion to laparotomy for complex cases.
- Intraoperative adaptability and multidisciplinary collaboration are crucial for optimal patient outcomes.
