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. 2009 Jul;1(2):73-82.
doi: 10.4103/0974-1216.71611.

Laparoscopic management of large myomas

Rakesh Sinha  1 , Meenakshi Sundaram
Affiliations

Laparoscopic management of large myomas

Rakesh Sinha et al. J Gynecol Endosc Surg. 2009 Jul.

Abstract

The objective of this article is to review the different techniques that have been adopted for removal of large myomas laparoscopically. We have also quoted literature about the impact of myomas on Pregnancy and obstetrical outcome and the effect of laparoscopic myomectomy on the same. Technical modifications to remove large myomas have been described along with methods to reduce intraoperative bleeding. This comprehensive review describes all possibilities of laparoscopic myomectomy irrespective of size, site and number.

Keywords: Laparoscopic myomectomy; fibroids; large myomas; pregnancy after myomectomy; uterine artery ligation.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
External picture of uterus with multiple fibroids
Figure 2
Figure 2
Uterus with large fundal fibroid
Figure 3
Figure 3
Uterus with multiple fibroids
Figure 4
Figure 4
Uterus with Broad ligament myoma
Figure 5
Figure 5
Uterus with lower segment fibroid
Figure 6
Figure 6
Veress at palmers point
Figure 7
Figure 7
10 mm scope inserted under vision of 5 mm
Figure 8
Figure 8
Vasopressin injected
Figure 9
Figure 9
Capsule dissected with bipolar and scissors
Figure 10
Figure 10
Capsule dissected with Harmonic Ultracision
Figure 11
Figure 11
Uterus with Pedunculated fibroid
Figure 12
Figure 12
Pedunculated fibroid being clamped
Figure 13
Figure 13
Uterine artery ligation
Figure 14
Figure 14
Uterus with fibroids before devascularisation
Figure 15
Figure 15
Uterus with fibroids after devascularisation
Figure 16
Figure 16
Enucleation of fibroid
Figure 17
Figure 17
Enucleation of fibroid by traction and counter traction
Figure 18
Figure 18
Suturing the myoma capsule
Figure 19
Figure 19
Morcellation
Figure 20
Figure 20
Placement of adhesion barrier
See this image and copyright information in PMC

References

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