Intraoperative transvaginal sonography: a novel approach for localization of deeper myomas during laparoscopic myomectomy

Abstract

The aim of this study is to assess the use of intraoperative transvaginal ultrasonography (TVS) to locate deep myomas that were not identified on laparoscopic view. The design of this study is a prospective observational study. This study was conducted in private Advanced Endoscopy and Infertility Treatment Centre, Kerala, India. The study comprised of 84 patients who underwent laparoscopic myomectomy from January 2011 to December 2013 in whom intraoperative TVS was used as an intervention. The number of additional deeper myomas removed was calculated, and recurrence at 1 year was calculated. The total number of myomas enucleated was 390, and the additional myomas enucleated after intraoperative TVS were 94. The recurrence of myomas at 1-year follow-up was 7.1 %. Intraoperative TVS was helpful to the surgeon for identifying deeper myomas making the surgery more effective.

The Use of intra-operative Ultrasound in Gynecological Surgery: a Review

“…The use of US allowed a successful myomectomy to be performed, preventing the need to convert to open surgery [9]. These benefits have been further investigated and reproduced in a number of prospective studies which confirm the ability of IOUS (endoscopic or transvaginal) to accurately localize and remove additional myomas that are not visible laparoscopically [43,44]. A recent study investigating the use of IOUS laparoscopically and transvaginally found LUS was more effective in localizing residual fibroids following laparoscopic myomectomy [45].…”

Intraoperative ultrasound assistance during myomectomy in pregnant woman

“…Previous studies have demonstrated the usefulness of IUS in identifying the location of deep myomas and the best site for uterine incision during laparoscopic myomectomy 2 , and in evaluating residual myomas after surgery 3,4 . Other studies have shown that, during open myomectomy, IUS with direct application of the probe onto the uterine serosa is more efficient than palpation in evaluating residual myomas at the end of the surgery 5 .…”

Intraoperative transvaginal ultrasound examination during myomectomy

“…Recently, intraoperative ultrasound examination has been proposed in this setting as a useful method to guide the surgeon during myomectomy. Paul et al demonstrated that intraoperative transvaginal ultrasound is helpful to the surgeon for identifying deeper myomas making the surgery more effective [4]. Other authors reported cases of an intraoperative ultrasound using a laparoscopic probe to guide surgeon to identify the correct placement of the uterine incision during laparoscopic myomectomy [5,6].…”