Intramural Myomectomy Using a Combination of Hysteroscopy and Laparoscopy

Thanks to advances in hysteroscopic surgery and improvements in instrumentation, hysteroscopy can now be performed for intramural myomas. Twelve women with submucous or intramural myomas with a diameter ranging from 3.5 to 5.8 cm received preoperative preparation with 5 months of gonadotropin-releasing hormone analogs. The uterine cavity was distended with sorbitol-mannitol solution infused by an electronic pump. Hysteroscopic resection was performed with a 26F resectoscope and electrosurgical monopolar unit under laparoscopic control in all patients. Four women required a second procedure to complete the resection of myoma. No major complications occurred.