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Laparoscopic myomectomy: enucleation of the myoma by morcellation while it is attached to the uterus.
J Minim Invasive Gynecol. 2005 May-Jun; 12(3):284-9.JM

Abstract

STUDY OBJECTIVE

To evaluate the feasibility, blood loss, length of surgery, mean hospital stay, and complications of enucleation of a myoma by morcellation while it is still attached to the uterus and to compare the technique with the standard technique of laparoscopic myomectomy.

DESIGN

Randomized study (Canadian Task Force classification II-2).

SETTING

Private endoscopy center.

PATIENTS

Forty-four patients with symptomatic myomas confirmed by ultrasound examination were included in the study from January 2000 through December 2001 and were randomized into two groups-A and B. The inclusion criteria were the presence of a uterus larger than 12 weeks (on bimanual examination), ultrasound confirmation of the presence of at least one myoma 7 cm or greater in size, and/or presence of three or more myomas greater than 5 cm in size.

INTERVENTION

The technique of laparoscopic myomectomy by enucleation of a myoma by morcellation while it is still attached to the uterus was performed in all patients in Group A. The patients in Group B underwent laparoscopic myomectomy by the conventional technique of complete enucleation of the myoma followed by morcellation.

MEASUREMENTS AND MAIN RESULTS

Forty-nine myomas were removed in group A and 35 in group B. The mean weight of the myomas removed in each patient was 600.5 +/- 369.1 g in group A (95% CI 452.83-748.17 g) and 584.2 +/- 411.1 g in group B (95% CI 404.05-764.45 g) (p = .706). The mean blood loss was 283.9 +/- 229.3 mL in group A (95% CI 192.20-375.72 mL) and 218.5 +/- 110.7 mL in group B (95% CI 169.96-267.04 mL) (p = .739), the mean hospital stay was 37.91 +/- 5.44 hours in group A (95% CI 35.74-40.10 hours) and 39.5 +/- 3.634 hours in group B (95% CI 37.91-41.09 hours) (p = .236). The mean length of surgery was significantly shorter in group A (97.7 +/- 27.06 min, 95% CI 86.88-108.54 minutes) as compared with that in group B (123 +/- 38.8 min 95% CI 106.93-140.57 minutes), (p = .013).

CONCLUSION

Preliminary results suggest that laparoscopic myomectomy employing the technique of enucleation of a myoma by morcellation while it is still attached to the uterus is safe and efficient. It helps to overcome certain technical difficulties inherent in the standard technique of laparoscopic myomectomy. It may help to relax the inclusion criteria of patients with myoma for laparoscopic myomectomy based on the size of the myoma.

Authors+Show Affiliations

Bombay Endoscopy Academy and Centre for Minimally Invasive Laser Surgery Research Co. Pvt. Ltd., Mumbai, India.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15922988

Citation

Sinha, Rakesh, et al. "Laparoscopic Myomectomy: Enucleation of the Myoma By Morcellation While It Is Attached to the Uterus." Journal of Minimally Invasive Gynecology, vol. 12, no. 3, 2005, pp. 284-9.
Sinha R, Hegde A, Warty N, et al. Laparoscopic myomectomy: enucleation of the myoma by morcellation while it is attached to the uterus. J Minim Invasive Gynecol. 2005;12(3):284-9.
Sinha, R., Hegde, A., Warty, N., & Mahajan, C. (2005). Laparoscopic myomectomy: enucleation of the myoma by morcellation while it is attached to the uterus. Journal of Minimally Invasive Gynecology, 12(3), 284-9.
Sinha R, et al. Laparoscopic Myomectomy: Enucleation of the Myoma By Morcellation While It Is Attached to the Uterus. J Minim Invasive Gynecol. 2005 May-Jun;12(3):284-9. PubMed PMID: 15922988.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic myomectomy: enucleation of the myoma by morcellation while it is attached to the uterus. AU - Sinha,Rakesh, AU - Hegde,Aparna, AU - Warty,Neeta, AU - Mahajan,Chaitali, PY - 2004/09/06/received PY - 2005/01/11/accepted PY - 2005/6/1/pubmed PY - 2005/9/15/medline PY - 2005/6/1/entrez SP - 284 EP - 9 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 12 IS - 3 N2 - STUDY OBJECTIVE: To evaluate the feasibility, blood loss, length of surgery, mean hospital stay, and complications of enucleation of a myoma by morcellation while it is still attached to the uterus and to compare the technique with the standard technique of laparoscopic myomectomy. DESIGN: Randomized study (Canadian Task Force classification II-2). SETTING: Private endoscopy center. PATIENTS: Forty-four patients with symptomatic myomas confirmed by ultrasound examination were included in the study from January 2000 through December 2001 and were randomized into two groups-A and B. The inclusion criteria were the presence of a uterus larger than 12 weeks (on bimanual examination), ultrasound confirmation of the presence of at least one myoma 7 cm or greater in size, and/or presence of three or more myomas greater than 5 cm in size. INTERVENTION: The technique of laparoscopic myomectomy by enucleation of a myoma by morcellation while it is still attached to the uterus was performed in all patients in Group A. The patients in Group B underwent laparoscopic myomectomy by the conventional technique of complete enucleation of the myoma followed by morcellation. MEASUREMENTS AND MAIN RESULTS: Forty-nine myomas were removed in group A and 35 in group B. The mean weight of the myomas removed in each patient was 600.5 +/- 369.1 g in group A (95% CI 452.83-748.17 g) and 584.2 +/- 411.1 g in group B (95% CI 404.05-764.45 g) (p = .706). The mean blood loss was 283.9 +/- 229.3 mL in group A (95% CI 192.20-375.72 mL) and 218.5 +/- 110.7 mL in group B (95% CI 169.96-267.04 mL) (p = .739), the mean hospital stay was 37.91 +/- 5.44 hours in group A (95% CI 35.74-40.10 hours) and 39.5 +/- 3.634 hours in group B (95% CI 37.91-41.09 hours) (p = .236). The mean length of surgery was significantly shorter in group A (97.7 +/- 27.06 min, 95% CI 86.88-108.54 minutes) as compared with that in group B (123 +/- 38.8 min 95% CI 106.93-140.57 minutes), (p = .013). CONCLUSION: Preliminary results suggest that laparoscopic myomectomy employing the technique of enucleation of a myoma by morcellation while it is still attached to the uterus is safe and efficient. It helps to overcome certain technical difficulties inherent in the standard technique of laparoscopic myomectomy. It may help to relax the inclusion criteria of patients with myoma for laparoscopic myomectomy based on the size of the myoma. SN - 1553-4650 UR - https://www.unboundmedicine.com/medline/citation/15922988/Laparoscopic_myomectomy:_enucleation_of_the_myoma_by_morcellation_while_it_is_attached_to_the_uterus_ DB - PRIME DP - Unbound Medicine ER -