Title: Laparoscopic Myomectomy—Complications and Conversion

Authors: Dr Kumar Sanjeev, MD., Dr Alla Satyanarayana Reddy, MD., DGO., FICMCH

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.92

Abstract

Objectives: To evaluate the conversion rate and complications of laparoscopic myomectomy

Material and Methods: It was a retrospective study of 43 cases of  laparoscopic myomectomy performed  over a period 28 months from  December 2015 to March 2018 at Vinayaka Mission`s Medical College & Hospital. Demography, indications for myomectomy, location and the number of fibroids, surgery done, difficulties and complications encountered and the necessity for conversion to open surgery were analysed.

Results: A total of 108myomas were removed on 43 patients. The mean age of patient undergoing laparoscopic myomectomy was 32.16 years.24 patients had only one fibroid. Only 5 patients had fibroids more than 4 in number. In 8 patients the largest fibroid was less than 5 cms, 6-12 cms in 34 women. One patient had fibroid measuring 15 cm. Of the 108 fibroids removed 80 were intramural. There was only one conversion to Laparotomy. Two patients had excessive blood loss and 8 patients had to be transfused blood intra operatively or postoperatively.

Conclusion: Our data suggests that laparoscopy is a safe and effective procedure for myomectomy even in 15 cms fibroids.

Keywords: laparoscopy,fibroids, myomectomy.

References

  1. Altgassen C, Kuss S, Berger U, Loning M, Diedrich K, Schneider A. Complications in laparoscopic myomectomy. SurgEndosc 2006;20:614-8.
  2. Stefano Palomba, M.D.,ErricoZupi, M.D., Angela Falbo, M.D.,Tiziana Russo, M.D., Daniela Marconi, M.D., Achille Tolino, M.D., Francesco Manguso, M.D.,Alberto Mattei, M.D., and Fulvio Zullo, M.DA multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes. Fertility and Sterility_ Vol. 88, No. 4, October 2007
  3. Jean-Bernard dubuisson, Arnaud Fauconnier, Virginie Fourchotte, Katayoun Babaki-Fard , Joel Coste ,and Charles Chapron..Laparoscopic Myomectomy: Predicting the risk of conversion to ana open procedure. Human reproduction vol16 , no. 8 pp. 1726-1731 ,2001
  4. Henri Marreta,, Muriel Chevillota, Bruno Giraudeau A retrospective multicentre study comparing myomectomy by laparoscopy and laparotomy in current surgical practiceWhat are the best patient selection criteria?European Journal of Obstetrics & Gynecology andReproductive Biology 117 (2004) 82–86
  5. PieroSeinera , Riccardo Arisio, Andrej Decko1, myomectomy, despite its technical difficulties. Claudio Farinaand Francesco Crana1Laparoscopic myomec-tomy: indications, surgical technique and complications Human Reproduction 12 no.9 pp.1927–1930, 1997
  6. Pei-Ju Wu, MD; Kai-Yun Wu, MD; Chien-Min Han, MD; Hsuan Su, MD; Chin-Jung Wang, MD; Chyi-Long Lee, MD, PhD Pierce and Push: A Simplified Method to Facilitate Laparoscopic Myomectomy (Chang Gung Med J 2012;35:160-6)

Corresponding Author

Dr Alla Satyanarayana Reddy

Professor & HOD, Department of Obstetrics & Gynaecology,

Vinayaka Mission`s Medical College & Hospital, Karaikal, Pondicherry, India. 609609

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.