Update on laparoscopic myomectomy

Liselotte Mettler, Thoralf Schollmeyer, Nimish R. Shelat, Walter Jonat
2005 Gynecological Surgery  
Our aim was to analyze the indications and factors influencing laparoscopic myomectomy and its outcome. A retrospective analysis was done of 178 patients who underwent laparoscopic myomectomy at the between 2000 and 2003. A detailed history was taken of all patients with uterine fibroids measuring <3->10 cm in diameter. Thirty-seven patients were pretreated with gonadotropin-releasing hormone analogues. Of the 178 patients with myomas, 24% had pedunculated-subserous fibroids, 76% had intramural
more » ... myomas, and none had diffuse myomatosis. The mean operating time for laparoscopic myomectomy was 90 min, and mean hospital stay was 2±0.5 days. The only complications encountered were in two patients with a small hematoma in the abdominal wall. No late complications were found. Seven of 178 cases required a second laparoscopic myomectomy. A pregnancy rate of over 55% was achieved in the infertility cases, with a 30% cesarean section rate. Postoperative recovery and resumption to normal life were quicker compared with laparotomy with low morbidity. Overall, laparoscopic myomectomies were performed for the following indications: pelvic mass (29%), metrorrhagia (17%), pelvic pain (14%), and infertility (40%). Laparoscopic myomectomy is the technique of choice for pedunculated-subserosal and intramural fibroids in properly selected cases. It requires a skilled endoscopic surgical unit and an efficient team and results in a very low morbidity. Submucous fibroids and diffuse myomatosis were not evaluated in this study.
doi:10.1007/s10397-005-0097-5 fatcat:ojrdtq3anbg5ppdcik2b52wuhq