Intraoperative ultrasound during a laparoscopic myomectomy

Abstract

Objective: To report a gynecologic use of a laparoscopic ultrasound transducer to isolate a myoma for surgical removal.

Design: Case report.

Setting: University-based infertility practice.

Patient(s): A 44-year-old woman gravida 1 para 1 with history of a first trimester miscarriage who desired pregnancy as a participant in the donor egg program.

Intervention(s): Before she entered the assisted reproduction program, a patient was found to have a myoma that was greater than 2 cm with both intramural and submucosal components. During the laparoscopic evaluation, a laparoscopic ultrasound transducer helped identify and properly locate the myoma in what otherwise appeared to be a normal uterus. Appropriate laparoscopic hysterotomy incision was then made, thereby minimizing uterine trauma.

Main outcome measure(s): Appropriately placed hysterotomy incision and successful reconstruction of uterus.

Result(s): After the successful laparoscopic myomectomy, the patient achieved a pregnancy in our donor oocyte program.

Conclusion(s): Laparoscopic intraoperative ultrasound can help gynecologic surgeons complete a laparoscopic myomectomy.