World Journal of Laparoscopic Surgery

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VOLUME 6 , ISSUE 2 ( May-August, 2013 ) > List of Articles

RESEARCH ARTICLE

Laparoscopic Myomectomy for Large Fibroids with Synchronized use of Uterine Artery Embolization

MW Kamran, TK Madhuri, WJ Walker, SA Butler-Manuel

Citation Information : Kamran M, Madhuri T, Walker W, Butler-Manuel S. Laparoscopic Myomectomy for Large Fibroids with Synchronized use of Uterine Artery Embolization. World J Lap Surg 2013; 6 (2):107-110.

DOI: 10.5005/jp-journals-10033-1193

Published Online: 01-08-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

To determine the feasibility and efficacy of the laparoscopic myomectomy for large fibroids (>10 cm) with use of synchronous uterine artery embolization.

Design

A prospective observational case series of laparoscopic myomectomy performed for single and multiple uterine fibroids.

Setting

A tertiary referral center for gynecological oncology and minimal access surgery.

Population

A 15 premenopausal women with large fibroids who wished to conserve their uterus from March 2005 to August 2011.

Materials and methods

Laparoscopic myomectomy was performed using harmonic scalpel with synchronized preoperative uterine artery embolization (UAE) following multidisciplinary team discussion. Tissue retrieval was performed by morcellation.

Main outcome measures

Early discharge and reduced intraoperative blood loss.

Results

Of all 15 cases, mean number of fibroids removed was 2 (range: 1-4) and mean mass of tissue excised was 450 gm (range: 320-1540). The mean diameter of the fibroids removed was 13 cm (range: 10-20 cm). Mean estimated blood loss was 156 ml (range: 25-1,000 ml) and the mean operating time was 113 minutes (17-200 minutes). All cases were successfully completed laparoscopically with no conversions to open surgery. One patient who had a 13 cm broad ligament fibroid required a 2 unit blood transfusion intraoperatively and another patient developed a single port-site infection 2 weeks following the procedure. Histology confirmed benign leiomyomas in all cases.

Conclusion

Laparoscopic myomectomy with use of synchronized UAE using harmonic scalpel is feasible and efficient procedure for single or multiple large fibroids within an experienced multidisciplinary setting.

How to cite this article

Kamran MW, Madhuri TK, Walker WJ, Butler-Manuel SA. Laparoscopic Myomectomy for Large Fibroids with Synchronized use of Uterine Artery Embolization. World J Laparosc Surg 2013;6(2):107-110.


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