Safe techniques in surgery for hysteroscopic myomectomy

Abstract

Hysteroscopic myomectomy is regarded as the best treatment for patients with submucous myomata. However, this procedure has a number of associated complications, including uterine perforation, cervical laceration, hyponatremia and hemorrhage, especially in cases of sessile submucous myomata. To avoid these problems, it is important to make well-advised preparations and manipulations both pre- and intraoperatively. The main surgical considerations for safe hysteroscopic myomectomy are shortening the operating time and avoiding cutting too deeply into the myometrium. With these requirements in mind, a combination of techniques using vaporization and a powerful oxytocic agent, such as prostaglandin F-2alpha, appears to be the safest method of carrying out hysteroresectoscopy for unpedunculated sessile submucous myomata.

The Effects of Hysteroscopic Submucosal Myoma Resection on Number of Sanitary Pads

“…If the cavity is fully emptied after the procedure febrile reaction should be prevented. After prophylactic antibiotic use 0.4% infection developed however Pyper et al did not use prophylactic antibiotics and did not report any postoperative infection [15][16][17][18][19]. The current study did not use prophylactic antibiotics however in the postoperative period a single dose of intravenous 1st generation cephalosporin group antibiotic was administered.…”

Hysteroscopic myomectomy in a submucous fibroid near from tubal ostia and 5 mm from the serosa: a case report from the Endoscopy Service of Ginendo-RJ

“…The complexity of the surgery is directly related to the size and localisation of the myoma in the uterine cavity. To obtain the best surgical result, correct submucous fibroid classification is necessary to select the surgical instruments, the technique and the appropriate team for difficult cases [5,9,10]. In our experience, only one parameter is not sufficient to estimate the degree of complexity in a hysteroscopic myomectomy.…”

Slice and Excise Technique in Hysterscopic Myomectomy for Large G0 Submucous Myoma

“…In this study, only large size 4-5cm grade 0 totally intracavitary myomas were included, eliminating the added difficulty of intramural extension of the myoma. A similar technique was described when approaching Go myomas, through cutting the base of the pedicle by a resectoscopic loop [30] or by a vaporizing electrode. The myomas is grasped blindly by the forceps and extracted.…”