Laparoscopic myomectomy – The importance of surgical techniques

Dumitrașcu, Mihai Cristian; Nenciu, Cătălin George; Nenciu, Adina-Elena; Călinoiu, Amalia Loredana; Neacşu, Adrian; Cîrstoiu, Monica Mihaela; Şandru, Florica

doi:10.3389/fmed.2023.1158264

Cited by 12 publications

(8 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laparoscopic myomectomy (LM) is a safe and effective technique for the treatment of women with fibroid uterus who wish to preserve future fertility. The laparoscopic approach has advantages over laparotomy of better and faster recovery, less postoperative pain, and lower risk of postoperative adhesion formation 10 , 11 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical impact of bilateral transient occlusion of uterine and utero-ovarian arteries during laparoscopic myomectomy

Moratalla-Bartolomé,

Lázaro-de-la-Fuente,

López-Carrasco

et al. 2024

Sci Rep

View full text Add to dashboard Cite

The objective of this article is to compare the amount of intraoperative blood loss during laparoscopic myomectomy when performing bilateral transient clamping of the uterine and utero-ovarian arteries versus no intervention. It´s a randomized controlled prospective study carried out in the Department of Obstetrics and Gynecology Ramón y Cajal University Hospital and HM Montepríncipe-Sanchinarro University Hospital, Madrid, Spain, in women with fibroid uterus undergoing laparoscopic myomectomy. Eighty women diagnosed with symptomatic fibroid uterus were randomly assigned to undergo laparoscopic myomectomy without additional intervention (Group A) or temporary clamping of bilateral uterine and utero-ovarian arteries prior to laparoscopic myomectomy (Group B). Estimated blood loss, operating time, length of hospital stay, and postoperative hemoglobin values were compared in both groups. The number of fibroids removed was similar in both groups (p = 0.77). Estimated blood loss was lower in the group of patients with prior occlusion of uterine arteries (p = 0.025) without increasing operating time (p = 0.17) nor length of stay (p = 0.17). No patient had either intra or postoperative complications. Only two patients (2.5%) required blood transfusion after surgery. We conclude that temporary clamping of bilateral uterine arteries prior to laparoscopic myomectomy is a safe intervention that reduces blood loss without increasing operative time.

show abstract

Section: Discussionmentioning

confidence: 99%

“…To prevent excessive intraoperative bleeding, different strategies have been proposed, including preoperative treatments with GnRH analogs, intramyometrial vasopressin injection, intraoperative misoprostol administration, intravenous oxytocin, and placement of a tourniquet around the cervix, among other options 2 , 11 – 13 .…”

Section: Discussionmentioning

confidence: 99%

Surgical impact of bilateral transient occlusion of uterine and utero-ovarian arteries during laparoscopic myomectomy

Moratalla-Bartolomé,

Lázaro-de-la-Fuente,

López-Carrasco

et al. 2024

Sci Rep

View full text Add to dashboard Cite

show abstract

“…However, laparoscopic myomectomy remains an option if individual cases are considered appropriate for the laparoscopic approach. 37 This technique was first performed by Kurt Semm in 1979. 38 Laparoscopy and Malignant Gynaecology.…”

Section: Laparoscopy and Benign Ovarian Cystsmentioning

confidence: 99%

Robot Assisted Laparoscopic Surgery in Gynaecology: An Evolving Assistive Technology

Xie,

Wood,

Dasgupta

et al. 2024

Surg Innov

View full text Add to dashboard Cite

Laparoscopic surgery is extensively utilized to treat a range of gynaecological conditions and pathologies. The advantages of laparoscopic surgery include the minimalization of blood loss and scarring, improved recovery times, and shorter hospital admissions. However, robotic technologies have had an increasing presence within gynaecological laparoscopic surgery in recent decades. This literature review therefore aims to discuss laparoscopy from 3 perspectives. First, the evolution of laparoscopy is reviewed with a focus on its origins, its transition from a diagnostic to an operative tool, and its role in present-day gynaecology. Second, interventions for benign gynaecological conditions (including excision of benign ovarian tumours, total laparoscopic hysterectomy, and laparoscopic myomectomy) are reviewed. The laparoscopic management of malignant gynaecology (including ovarian cancer, endometrial cancer, and cervical cancer) is also discussed. Finally, whilst robot-assisted laparoscopic surgery is experiencing rapid technological advancement, it is pertinent to consider the extent of its benefits when compared to open or conventional laparoscopic approaches in gynaecological surgery.

show abstract

“…Uterine fibroids represent the most prevalent benign tumors of the female reproductive organs, with an incidence of 25-40% among women of childbearing age [ 1 , 2 ]. Laparoscopic myomectomy has indeed emerged as the most common surgical approach, especially for individuals who desire to preserve their reproductive ability [ 3 ]. And the management of intraoperative bleeding is essential to the success of the procedure.…”

Section: Introductionmentioning

confidence: 99%

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

Wang,

Zhao,

Chen

et al. 2024

BMC Anesthesiol

View full text Add to dashboard Cite

Background This study aimed to determine the median effective dose (ED50) and 95% effective dose (ED95) of nicardipine for treating pituitrin-induced hypertension during laparoscopic myomectomy, providing guidance for the management of intraoperative blood pressure in such patients. Methods Among the initial 40 participants assessed, 24 underwent elective laparoscopic myomectomy. A sequential up-and-down method was employed to ascertain the ED50 of nicardipine based on its antihypertensive efficacy. Nicardipine was initially administered at 6 µg/kg following the diagnosis of pituitrin-induced hypertension in the first patient. Dosing adjustments were made to achieve the desired antihypertensive effect, restoring systolic blood pressure and heart rate to within ± 20% of baseline within 120 s. The dosing increment or reduction was set at 0.5 µg/kg for effective or ineffective responses, respectively. The ED50 and ED95 of nicardipine were calculated using Probit regression by Maximum Likelihood Estimation (MLE) to establish dose-response curves and confidence intervals. Results 24 patients were included for analysis finally. The ED50 and ED95 of nicardipine for blood pressure control after pituitrin injection were determined. The study found that the ED50 of nicardipine for treating pituitrin-induced hypertension was 4.839 µg/kg (95% CI: 4.569–5.099 µg/kg), and the ED95 was estimated at 5.308 µg/kg (95% CI: 5.065–6.496 µg/kg). Nicardipine effectively mitigated the hypertensive response caused by pituitrin without inducing significant tachycardia or hypotension. Conclusions Nicardipine effectively controlled blood pressure after pituitrin injection during laparoscopic myomectomy, with ED50 and ED95 values established. This research highlights the potential utility of nicardipine in addressing hypertensive responses induced by pituitrin, particularly in clinical settings where pituitrin is routinely administered.

show abstract

Laparoscopic myomectomy – The importance of surgical techniques

Cited by 12 publications

References 71 publications

Surgical impact of bilateral transient occlusion of uterine and utero-ovarian arteries during laparoscopic myomectomy

Surgical impact of bilateral transient occlusion of uterine and utero-ovarian arteries during laparoscopic myomectomy

Robot Assisted Laparoscopic Surgery in Gynaecology: An Evolving Assistive Technology

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

Contact Info

Product

Resources

About