Prospective Evaluation for the Feasibility and Safety of Vaginal Birth after Laparoscopic Myomectomy

Kumakiri, Jun; Takeuchi, Hisaya; Kitade, Mari; Kikuchi, Iwaho; Takeda, Satoru

doi:10.1016/j.jmig.2008.09.222

Cited by 4 publications

(12 citation statements)

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“…This result is comparable to those of laparoendoscopic multiple-port myomectomy reported in large-scale case series (6.40-6.72 cm). [10][11][12] Moreover, RSSM was successfully completed in women who had 12 multiple myomas, and women with the largest myoma in a posterior location or deep intramural type (FIGO type 4) comprised a large proportion of this study population. In the past, some surgeons suggested that laparoendoscopic myomectomy should be restricted in cases of myomas <8.0 cm and < 2 myomas to be removed.…”

Section: Discussionmentioning

confidence: 99%

Robotic single‐site myomectomy: A single‐center experience of 101 consecutive cases

Kim

Jung

Yun

et al. 2018

Robotics Computer Surgery

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Background To evaluate the feasibility and clinical outcomes of robotic single‐site myomectomy (RSSM) for uterine myoma. Methods Medical records of 101 consecutive women who underwent RSSM were retrospectively reviewed, and patient characteristics and surgical outcomes were evaluated. The surgical outcomes were compared by the phase in learning curve (early phase of <10 cases vs late phase of ≥10 cases) and time flow. Results A total of 47 (46.5%) women had multiple myomas, and a median two (1‐12) myomas were retrieved. The largest myoma was averagely measured as 6.2 ± 1.7 cm, and the mean weight of the total retrieved myomas was 114.0 ± 84.4 g. No patients received a transfusion or had operation‐related complications. Cases in the late phase showed shorter port placement time and docking time than those in the early phase. Conclusions Our data suggest that robotic single‐site surgery is a feasible therapeutic option for uterine myoma.

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Section: Discussionmentioning

confidence: 99%

Robotic single‐site myomectomy: A single‐center experience of 101 consecutive cases

Kim

Jung

Yun

et al. 2018

Robotics Computer Surgery

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“…As one of the factors influencing fertility, it is suggested that uterine contractions may be compromised in cases of a scarred uterus due to a lack of connections between myometrial fibers; the degree of compromise would be dependent upon the degree of myometrial penetration. We previously reported that the failure of an attempted vaginal delivery after LM may possibly be due to ineffective uterine contractions (12). Moreover, it has been suggested that peristalsis of the nonpregnant uterus plays an important role for sperm transport and the presence of a submucosal myoma or an intrauterine device produce an abnormality of uterine peristalsis depending on the phase of the menstruation cycle (20,21).…”

Section: Discussionmentioning

confidence: 99%

“…Inclusion criteria comprise a uterine size equivalent to <16 weeks' gestation (immediately before LM) and less than 10 intramural myomas; however, the position (anterior wall, posterior wall, or fundal) and depth (such as intramural or submucosal) of the myomas were not considered as exclusion criteria. Our surgical procedure for LM has been previously described (12). In brief, we use the four-puncture method under general anesthesia with endotracheal intubation and with the patient in the lithotomy position.…”

Section: Methodsmentioning

confidence: 99%

“…All patients who underwent LM at our hospital and planned to become pregnant after surgery were given a thorough explanation of the benefits and risks of a vaginal delivery; they were offered the option of a vaginal delivery under strict perinatal management (12). The protocol of vaginal birth after LM was patterned on the recommendations on vaginal birth after cesarean section proposed by the American College of Obstetricians and Gynecologists (13).…”

Section: Methodsmentioning

confidence: 99%

“…The protocol of vaginal birth after LM was patterned on the recommendations on vaginal birth after cesarean section proposed by the American College of Obstetricians and Gynecologists (13). Patients who underwent SLL and become pregnant by December 2006 and were included in the present study had also been included in the previous study (12).…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy

Kumakiri

Kikuchi

Kitade

et al. 2010

Acta Obstet Gynecol Scand

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Trial of labor after myomectomy and uterine rupture: a systematic review

Gambacorti‐Passerini

Gimovsky

Locatelli

et al. 2016

Acta Obstet Gynecol Scand

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Introduction. There is concern about the risk of uterine rupture in the subsequent pregnancy after myomectomy. This risk is reported in literature to be around 0.7-1%. The aim of this study was to evaluate the incidence of uterine rupture and associated risk factors in women who had a trial of labor after prior myomectomy. Material and methods. A systematic review of the literature was performed including all cohort studies with at least five cases reporting outcomes of pregnancies after prior myomectomy. The terms "myomectomy", "pregnancy", "trial of labor" and "uterine rupture" were used in PubMed and EMBASE searches for identification purposes. Every reference was reviewed for possible inclusion and all eligible cases of uterine rupture were considered. Results. Twenty-three studies with at least five cases of pregnancy after myomectomy were identified, with an overall incidence of uterine rupture of 0.6% (0.3-1.1%) (n = 11/1825). Of these 23 studies, 11 studies reported detailed data about trial of labor after myomectomy and related pregnancy outcomes, including 1034 pregnancies and 756 viable (≥24 weeks) deliveries. The overall incidence of uterine rupture after myomectomy in the included studies was 0.93% (0.45-1.92%) (n = 7/756); specifically, it was 0.47% (0.13-1.70%) (n = 2/426) in women undergoing trial of labor after myomectomy, and 1.52% (0.65-3.51%) (n = 5/330) in women before the onset of labor. Of the seven uterine ruptures, five (71%) occurred within 36 weeks (range 24-40 weeks). Conclusions. Trial of labor after myomectomy is associated with a 0.47% risk of uterine rupture. There were no identified risk factors among the variables studied. The present systematic review of the literature revealed that uterine rupture after prior myomectomy occurred mainly before 36 weeks and before labor.

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Prospective Evaluation for the Feasibility and Safety of Vaginal Birth after Laparoscopic Myomectomy

Cited by 4 publications

References 0 publications

Robotic single‐site myomectomy: A single‐center experience of 101 consecutive cases

Robotic single‐site myomectomy: A single‐center experience of 101 consecutive cases

Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy

Trial of labor after myomectomy and uterine rupture: a systematic review

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