Ultra-Minilaparotomy Myomectomy: A Minimally Invasive Surgical Approach for the Treatment of Large Uterine Myomas

Ciavattini, Andrea; Tsiroglou, Dimitrios; Litta, Pietro; Frizzo, Helga; Tranquilli, Andrea Luigi

doi:10.1159/000227764

Cited by 15 publications

(5 citation statements)

References 53 publications

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“…There is more evidence supporting the advantages of UMLT with/without laparoscopic assistance, not only in providing similarly effective symptom relief, but also in requiring only easy‐to‐perform techniques and less expensive instruments in treating symptomatic women with uterine myomas, compared with conventional exploratory laparotomy for myomectomy. The recent publications focusing on the topic of MLT or UMLT for myomectomy are summarized in Table 2 15–18,57,76–81 . Therefore, we recommend that women with a diagnosis of uterine myomas with a limited number (no more than 5) and size (no more than 8 cm in size) be considered as candidates for UMLT with/without laparoscopic assistance, if they want to undergo myomectomy treatment.…”

Section: Resultsmentioning

confidence: 99%

“…The recent publications focusing on the topic of MLT or UMLT for myomectomy are summarized in Table 2. [15][16][17][18]57,[76][77][78][79][80][81] Therefore, we recommend that women with a diagnosis of uterine myomas with a limited number (no more than 5) and size (no more than 8 cm in size) be considered as candidates for UMLT with/without laparoscopic assistance, if they want to undergo myomectomy treatment. This comment is based on findings in our previous studies, [15][16][17][18] since the experience or evidence of using UMLT in the management of more complicated uterine myomas has not been established.…”

Section: Resultsmentioning

confidence: 99%

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Myomectomy for uterine myomas through ultramini‐laparotomy

Wen¹,

Sung

Lee

et al. 2011

J of Obstet and Gynaecol

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Uterine fibroids are the most common benign tumors in the female reproductive tract during the reproductive years. Among the options in the treatment spectrum, myomectomy is always considered one of the best choices in the management of women with symptomatic uterine fibroids who wish to preserve future fertility. Myomectomy through conventional exploratory laparotomy may be the most familiar surgical approach. However, with the advances being made in techniques and instruments, there are many alternative approaches to myomectomy, including mini-laparotomy, ultramini-laparotomy, laparoscopy, laparoscopy-aided, and vaginal and hysteroscopic approaches. The focus of this review article is limited to discussing the use of the ultramini-laparotomy approach to completing myomectomy in the management of the uterine fibroids.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Myomectomy for uterine myomas through ultramini‐laparotomy

Wen¹,

Sung

Lee

et al. 2011

J of Obstet and Gynaecol

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“…Abdominal myomectomy, also known as open myomectomy, may be considered when the uterus is significantly enlarged, typically above the level of the umbilicus, and/or when multiple myomas are present. The surgical approach to myomectomy however, should be highly individualized, taking into consideration other factors, such as prior surgical history and patient’s comorbid conditions 24. Some of the advantages of abdominal myomectomy include no limitations on the size and the number of fibroids to be removed, the ability to palpate and completely remove all the myomas, and perhaps, ease of the open surgery technique depending on the surgeon’s experience and skills 25.…”

Section: Surgical Techniques For Myomectomymentioning

confidence: 99%

Robot-assisted laparoscopic myomectomy: current status

Arian

Munoz

Kim

et al. 2017

RSRR

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Robotic-assisted surgery has seen a rapid development and integration in the field of gynecology. Since the approval of the use of robot for gynecological surgery and considering its several advantages over conventional laparoscopy, it has been widely incorporated especially in the field of reproductive surgery. Uterine fibroids are the most common benign tumors of the female reproductive tract. Many reproductive-aged women with this condition demand uterine-sparing surgery to preserve their fertility. Myomectomy, the surgical excision of uterine fibroids, remains the only surgical management option for fibroids that entails preservation of fertility. In this review, we focus on the role of robotic-assisted laparoscopic myomectomy and its current status, in comparison with other alternative approaches for myomectomy, including open, hysteroscopic, and traditional laparoscopic techniques. Several different surgical techniques have been demonstrated for robotic myomectomy. This review endeavors to share and describe our surgical experience of using the standard laparoscopic equipment for roboticassisted myomectomy, together with the da Vinci Robot system. For the ideal surgical candidate, robotic-assisted myomectomy is a safe minimally invasive surgical procedure that can be offered as an alternative to open surgery. The advantages of using the robot system compared to open myomectomy include a shorter length of hospital stay, less postoperative pain and analgesic use, faster return to normal activities, more rapid return of the bowel function, and enhanced cosmetic results due to smaller skin incision sizes. Some of the disadvantages of this technique include high costs of the robotic surgical system and equipment, the steep learning curve of this novel system, and prolonged operative and anesthesia times. Robotic technology is a novel and innovative minimally invasive approach with demonstrated feasibility in gynecological and reproductive surgery. This technology is expected to take the lead in gynecological surgery in the upcoming decade.

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“…The most crucial factor is the patients' desire for future fertility. These patients usually opt for a conservative approach, which ranges from observing the fibroid, medical therapy and myomectomy 5 . Abdominal myomectomy is the mainstay of conservative surgical treatment for uterine fibroids, particularly in women who wish to retain their uterus 6 .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Uterine Leiomyomas Size on Presenting Symptoms and Accurate Sonography Assessment

Bushaqer¹,

Dayoub²,

Rep³

2014

BMB

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Background: Uterine leiomyomas are the most common uterine neoplasm; their symptoms could be related to the size and position. They could affect patients' capability to conceive and/or to continue the pregnancy. Ultrasound is the main diagnostic tool. However, accurate assessment might be affected by fibroid characteristics. Objective: To evaluate the relationship between fibroid size, presenting symptoms, previous obstetric history and accurate ultrasound fibroid assessment preoperatively in patients who had abdominal myomectomy. Design: A retrospective data analysis. Setting: University of Dammam Teaching Hospital. Method: All patients who had abdominal myomectomy between 1 December 2007 and 30 November 2012 were reviewed. Personal characteristics, obstetric history, indication for the myomectomy and myoma preoperative and intraoperative features were reviewed. Result: One hundred thirty-seven procedures were performed during the study period. The mean age of the patients was 36 years, 81 (59.1%) were married and 112 (82%) were Saudi nationals. Menorrhagia was the leading presentation in 66 (48.2%) patients, followed by pain in 26 (19%), mass in 16 (12%), sub-fertility in 14 (10.2%) and pressure symptoms in 9 (7%) patients. However, 6 (4.4%) had combined presentations. The median of the two largest diameter myoma was 7 cm and the weight was 320 gm. However, fibroid size had a significant effect on the presenting symptoms. Previous parity was not affected by the size of the fibroid. The size of the fibroid on ultrasound had no effect on the accuracy of the assessment.

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Ultra-Minilaparotomy Myomectomy: A Minimally Invasive Surgical Approach for the Treatment of Large Uterine Myomas

Cited by 15 publications

References 53 publications

Myomectomy for uterine myomas through ultramini‐laparotomy

Myomectomy for uterine myomas through ultramini‐laparotomy

Robot-assisted laparoscopic myomectomy: current status

The Effect of Uterine Leiomyomas Size on Presenting Symptoms and Accurate Sonography Assessment

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