Uterine fibroids: place and modalities of laparoscopic treatment

Only fibroids which give rise to symptoms resistant to properly conducted medical treatment and/or complicated myomas require surgical treatment. The possibility offered by the new surgical approaches enables myomectomies to be now carried out via laparoscopy. We report our technique of laparoscopic myomectomy performed since 1989. Monopolar coagulation is used for the uterine incision, after myomectomy, myometrium and serosa are sutured. Myomas are removed through the suprapubic puncture site after fragmentation of large myomas, through a colpotomy or using the morcellator. Our results enable us to say that, although it is a difficult technique, laparoscopic myomectomy is a safe and reliable technique even for large intramural myomas.