Skip to main content
SpringerLink
Log in
Book cover

Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology pp 46–52Cite as

Laparoscopic Myomectomy

  • Chapter

  • 272 Accesses

Abstract

The technique of laparoscopic myomectomy (LM) only appeared recently, with the first cases being described for subserous fibroids in the 1980s.1,2 Since the beginning of the 1990s, several teams in Europe and the USA have reported their experience with LM for interstitial fibroids.3–6 Although there is still some hesitation, use of LM is becoming more widespread and the large number of studies addressing the subject show that the technique has reached maturity.3,5–27 It has been the subject of several prospective randomised studies,16,28,29 one of which compared the LM technique with laparotomy. Our own team has considerable experience in the use of LM: between March 1989 and July 1998 we carried out 373 procedures. The purpose of this chapter is to focus on the operative technique and to describe the advantages, limitations and risks involved.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kolmorgen K (1989) [Ovariectomy by laparoscopy]. Zen– tralbl Gynakol 111(9):613–617

    CAS  Google Scholar 

  2. Semm K, Mettler L (1980) Technical progress in pelvic surgery via operative laparoscopy. Am J Obstet Gynecol 138(2):121–127

    PubMed  CAS  Google Scholar 

  3. Daniell JF, Gurley LD (1991) Laparoscopic treatment of clinically significant symptomatic uterine fibroids. J Gynecol Surg 7:37–40

    Article  Google Scholar 

  4. Dubuisson JB, Lecuru F, Foulot H et al (1991) Myomectomy by laparoscope a preliminary report of 43 cases. Fertil Steril 56(5):827–830

    PubMed  CAS  Google Scholar 

  5. Hasson HM, Rotman C, Rana N et al (1992) Laparoscopic myomectomy. Obstet Gynecol 80(5):884–888

    PubMed  CAS  Google Scholar 

  6. Nezhat C, Nezhat F, Silfen SL et al (1991) Laparoscopic myomectomy. Int J Fertil 36(5):275–280

    PubMed  CAS  Google Scholar 

  7. Adamian LV, Kulakov VI, Kiselev SI et al (1996) Laparoscopic myomectomy in treatment of large myomas. J Am Assoc Gynecol Laparosc 3(4) (Suppl):S1

    Google Scholar 

  8. Andrei B (1996) Myomectomy by pelvicoscopy. Int Surg 81 (3):271–275

    PubMed  CAS  Google Scholar 

  9. Bulletti C, Polli V, Negrini V et al (1996) Adhesion formation after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 3(4):533–536

    Article  PubMed  CAS  Google Scholar 

  10. Carter JE, McCarus S, Baginiski L et al (1996) Laparoscopic outpatient treatment of large myomas. J Am Assoc Gynecol Laparosc 3(4)(Suppl):S6

    Google Scholar 

  11. Cittadini E (1998) Laparoscopic myomectomy: the Italian experience. J Am Assoc Gynecol Laparosc 5(l):7–9

    Article  PubMed  CAS  Google Scholar 

  12. Darai E, Deval B, Darles C et al (1996) Myomectomie: coelioscopie ou laparotomie. Contracept Fertil Sex 24 (10):751–756

    PubMed  CAS  Google Scholar 

  13. Dubuisson JB, Chapron C (1994) Laparoscopic myomectomy. Operative procedure and results. Ann NY Acad Sei 734:450–454

    Article  CAS  Google Scholar 

  14. Keckstein J, Karageorgieva E, Darwish A et al (1994) Laparoscopic myomectomy: sonographic follow–up and second–look laparoscopy for the evaluation of a new technique. J Am Assoc Gynecol Laparosc l(4)(Pt 2):S16

    Google Scholar 

  15. Kolmorgen K (1995) [Laparoscopic myomectomy]. Zentralbl Gynakol 117(12):659–662

    PubMed  CAS  Google Scholar 

  16. Mais V, Ajossa S, Guerriero S et al (1996) Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol 174(2):654–658

    Article  PubMed  CAS  Google Scholar 

  17. Mangeshikar PR (1995) New instrumentation and technique for laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 2(4)(Suppl):S29

    Article  Google Scholar 

  18. Mecke H, Wallas F, Brocker A et al (1995) [Pelviscopic myoma enucleation: technique, limits, complications]. Geburtshilfe Frauenheilkd 55(7):374–379

    Article  PubMed  CAS  Google Scholar 

  19. Mettler L, Alvarez–Rodaz E, Semm K (1995) Myomectomy by laparoscopy: a report of 482 cases. Gynaecol Endosc 4:259–264

    Google Scholar 

  20. Miller CE, Johnston M, Rundell M (1996) Laparoscopic myomectomy in the infertile woman. J Am Assoc Gynecol Laparosc 3(4):525–532

    Article  PubMed  CAS  Google Scholar 

  21. Montevecchi L, Bagnini C, Campo S et al (1995) Laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 2(4) (Suppl):S34

    Article  Google Scholar 

  22. Ostrzenski A (1997) A new laparoscopic myomectomy technique for intramural fibroids penetrating the uterine cavity. Eur J Obstet Gynecol Reprod Biol 74(2):189–193

    Article  PubMed  CAS  Google Scholar 

  23. Parker WH, Rodi IA (1994) Patient selection for laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 2(l):23–26

    Article  PubMed  CAS  Google Scholar 

  24. Reich H (1995) Laparoscopic myomectomy. Obstet Gynecol Clin North Am 22(4):757–780

    PubMed  CAS  Google Scholar 

  25. Seinera P, Arisio R, Decko A et al (1997) Laparoscopic myomectomy: indications, surgical technique and complications. Hum Reprod 12(9):1927–1930

    Article  PubMed  CAS  Google Scholar 

  26. Stringer NH (1996) Laparoscopic myomectomy in African– American women. J Am Assoc Gynecol Laparosc 3(3):375–381

    Article  PubMed  CAS  Google Scholar 

  27. Wood EC, Maher P (1995) New strategies for endoscopic myomectomy. J Am Assoc Gynecol Laparosc 2(4)(Suppl):S60–61

    Google Scholar 

  28. Mais V, Ajossa S, Piras B et al (1995) Prevention of de–novo adhesion formation after laparoscopic myomectomy: a randomized trial to evaluate the effectiveness of an oxidized regenerated cellulose absorbable barrier. Hum Reprod 10 (12):3133–3135

    PubMed  CAS  Google Scholar 

  29. Zullo F, Pellicano M, De Stefano R et al (1998) A prospective randomized study to evaluate leuprolide acetate treatment before laparoscopic myomectomy: efficacy and ultrasonographic predictors. Am J Obstet Gynecol 178(l)(Pt 1):108–112

    Article  PubMed  CAS  Google Scholar 

  30. Nezhat C, Nezhat F, Bess O et al (1994) Laparoscopically assisted myomectomy: a report of a new technique in 57 cases. Int J Fertil Menopausal Stud 39(l):39–44

    PubMed  CAS  Google Scholar 

  31. Chang FH, Soon YK, Lee CL et al (1996) Laparoscopic removal of a large leiomyoma using airlift gasless laparoscopy. J Am Assoc Gynecol Laparosc 3(4)(Suppl):S7

    Article  PubMed  Google Scholar 

  32. Goldfarb H (1995) Laparoscopic coagulation of myomas (myolysis). Obstet Gynecol Clin N Am 22:807–819

    CAS  Google Scholar 

  33. Nisolle M, Smets M, Malvaux V et al (1993) Laparoscopic myolysis with the Nd Yag laser. J Gynecol Surg 9:95–98

    Article  PubMed  CAS  Google Scholar 

  34. Olive DL, Rutherford T, Zreik T et al (1996) Cryomyolysis in the conservative treatment of uterine fibroids. J Am Assoc Gynecol Laparosc 3(4)(Suppl):S36

    Google Scholar 

  35. Dubuisson JB, Chapron C, Fauconnier A et al (1997) Laparoscopic myomectomy and myolysis. Curr Opin Obstet Gynecol 9(4):233–238

    PubMed  CAS  Google Scholar 

  36. Bonney V (1931) The technique and results of myomectomy. Lancet 220:171–173

    Article  Google Scholar 

  37. Buttram VC, Reiter R (1981) Uterine leiomyomata: etiology, symptomatology and management. Fertil Steril 36:433–445

    PubMed  Google Scholar 

  38. Vollenhoven BJ, Lawrence AS, Hely DL (1990) Uterine fibroids: a clinical review. Br J Obstet Gynaecol 97:285–298

    Article  PubMed  CAS  Google Scholar 

  39. Acien P, Quereda F (1996) Abdominal myomectomy: results of a simple operative technique. Fertil Steril 65(1):41–51

    PubMed  CAS  Google Scholar 

  40. Farrer–Brown G, Beilby J, Tarbit MH (1971) Venous changes in the endometrium of myomatous uteri. Obstet Gynecol 38:743

    PubMed  CAS  Google Scholar 

  41. Dubuisson JB, Chavet X, Chapron C et al (1995) Uterine rupture during pregnancy after laparoscopic myomectomy. Hum Reprod 10(6):1475–1477

    PubMed  CAS  Google Scholar 

  42. Harris WJ (1992) Uterine dehiscence following laparoscopic myomectomy. Obstet Gynecol 80(3):545–546

    PubMed  CAS  Google Scholar 

  43. Elkins TE, Stoval TG, Warren J et al (1987) A histologic evaluation of peritoneal injury and repair. Obstet Gynecol 70:225–228

    PubMed  CAS  Google Scholar 

  44. Hasson H (1996) Laparoscopic myomectomy. Infertil Reprod Med Clin N Am 7(1):143–159

    Google Scholar 

  45. Palerme G, Friedman E (1966) Rupture of the gravid uterus in the third trimester. Am J Obstet Gynecol 94(4):571–576

    PubMed  CAS  Google Scholar 

  46. Davids AM (1957) Myomectomy in the relief of infertility and sterility and in pregnancy. Surg Clin North Am 37:563

    PubMed  CAS  Google Scholar 

  47. Verkauf BS (1992) Myomectomy for fertility enhancement and preservation. Fertil Steril 58(1):1–15

    PubMed  CAS  Google Scholar 

  48. Buckman R, Buckman P, Hufnagel H et al (1976) A physiologie basis for the adhesion free healing of deper– itonealized surfaces. J Surg Res 21:67–76

    Article  PubMed  Google Scholar 

  49. Dubuisson JB, Fauconnier A, Chapron C et al (1998) Second– look after laparoscopic myomectomy. Hum Reprod 13 (8):2102–2106

    Article  PubMed  CAS  Google Scholar 

  50. MacDonald M, Elkins TE, Wortham GF et al (1988) Adhesion formation and prevention after peritoneal injury and repair in the rabbit. J Reprod Med 33:436–439

    Google Scholar 

  51. Dubuisson JB, Chapron C, Chavet X et al (1995) Traitement coeliochirurgical des volumineux fibromes utérins. Technique opératoire et résultats. J Gynecol Obstet Biol Reprod 24 (7):705–710

    CAS  Google Scholar 

  52. Steiner R, Wight E, Tadir Y et al (1993) Electrical device for removal of tissue from the abdominal cavity. Obstet Gynecol 81:471–474

    PubMed  CAS  Google Scholar 

  53. Carter JE, McCarus SD (1997) Laparoscopic myomectomy. Time and cost analysis of power vs manual morcellation. J Reprod Med 42(7):383–388

    PubMed  CAS  Google Scholar 

  54. Starks GC (1988) C02 laser myomectomy in an infertile population. J Reprod Med 33(2):184–186

    PubMed  CAS  Google Scholar 

  55. Stringer NH, Strassner HT (1996) Pregnancy in five patients after laparoscopic myomectomy with the harmonic scalpel. J Gynecol Surg 12:129–133

    Article  Google Scholar 

  56. Boike GM, Miller CE, Spirtos NM et al (1995) Incisional bowel herniations after operative laparoscopy: a series of nineteen cases and review of the literature. Am J Obstet Gynecol 172(6):1726–1733

    Article  PubMed  CAS  Google Scholar 

  57. Chang FH, Soong YK, Cheng PJ et al (1995) Laparoscopic repair of bowel herniation through previous cannula insertion sites. J Am Assoc Gynecol Laparosc 2(4):489–492

    Article  PubMed  CAS  Google Scholar 

  58. Kurtz BR, Daniell JF, Spaw AT (1993) Incarcerated incisional hernia after laparoscopy. A case report. J Reprod Med 38 (8):643–644

    PubMed  CAS  Google Scholar 

  59. Dubuisson JB, Chapron C, Levy L (1996) Difficulties and complications of laparoscopic myomectomy. J Gynecol Surg 12:159–165

    Article  Google Scholar 

  60. Stringer NH, Walker JC, Meyer PM (1997) Comparison of 49 laparoscopic myomectomies with 49 open myomectomies. J Am Assoc Gynecol Laparosc 4(4):457–464

    Article  PubMed  CAS  Google Scholar 

  61. Diamond MP (1996) Reduction of adhesions after uterine myomectomy by Seprafilm membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Seprafilm Adhesion Study Group. Fertil Steril 66(6):904–910

    PubMed  CAS  Google Scholar 

  62. Myomectomy Adhesion Multicenter Study Group (1995) An expanded polytetrafluoroethylene barrier (Gore–Tex surgical membrane) reduces post–myomectomy adhesion formation. Fertil Steril 63(3):491–493

    Google Scholar 

  63. Tulandi T, Murray C, Guralnick M (1993) Adhesion formation and reproductive outcome after myomectomy and second–look laparoscopy. Obstet Gynecol 82:213–215

    PubMed  CAS  Google Scholar 

  64. Ugur M, Turan C, Mungan T et al (1996) Laparoscopy for adhesion prevention following myomectomy. Int J Gynaecol Obstet 53(2):145–149

    Article  PubMed  CAS  Google Scholar 

  65. Dubuisson J, Fauconnier A, Chapron C et al (2000) Reproductive outcome after laparoscopic myomectomy in infertile women. J Reprod Med 45:23–30.

    PubMed  CAS  Google Scholar 

  66. Dubuisson JB, Chapron C (1996) Laparoscopic myomectomy today. A good technique when correctly indicated. Hum Reprod ll(5):934–935

    PubMed  CAS  Google Scholar 

  67. Friedmann W, Maier RF, Luttkus A et al (1996) Uterine rupture after laparoscopic myomectomy. Acta Obstet Gynecol Scand 75(7):683–684

    Article  PubMed  CAS  Google Scholar 

  68. Pelosi M, Pelosi MA (1997) Spontaneous uterine rupture at thirty–three weeks subsequent to previous superficial laparoscopic myomectomy. Am J Obstet Gynecol 177(6): 1547–1549

    Article  PubMed  Google Scholar 

  69. Tulandi T, Youssef H (1997) Laparoscopy assisted myomectomy of large uterine myomas. Gynaecol Endosc 6:105–108

    Article  Google Scholar 

  70. Brown AB, Chamberlain R, Te Linde RW (1956) Myomectomy. Am J Obstet Gynecol 71:759–763

    PubMed  CAS  Google Scholar 

  71. Davids A (1952) Myomectomy: surgical technique and results in series of 1150 cases. Am J Obstet Gynecol 63:592–604

    PubMed  CAS  Google Scholar 

  72. Finn WF, Muller PF (1950) Abdominal myomectomy: special reference to subsequent pregnancy and to the reappearance of fibromyomas of the uterus. Am J Obstet Gynecol 60:109

    PubMed  CAS  Google Scholar 

  73. Garnet J (1964) Uterine rupture during pregnancy. Obstet Gynecol 23:898

    PubMed  CAS  Google Scholar 

  74. Georgakopoulos P, Bersis G (1981) Sigmoido–uterine rupture in, pregnancy after multiple myomectomy. Int Surg 66:367–368

    PubMed  CAS  Google Scholar 

  75. Golan D, Aharoni A, Gonon R et al (1990) Early spontaneous rupture of the post myomectomy gravid uterus. Int J Gynaecol Obstet 31:167–170

    Article  PubMed  CAS  Google Scholar 

  76. Quakernack K, Bordt J, Nienhaus H (1980) [Placenta percreta and rupture of the uterus]. Geburtshilfe und Frauenheilkunde 40(6):520–523

    Article  PubMed  CAS  Google Scholar 

  77. Yaron Y, Shenhav M, Jaffa A et al (1994) Uterine rupture at 33 week’s gestation subsequent to hysteroscopic perforation. Am J Obstet Gynecol 170:786–787

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Jean-Bernard Dubuisson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arnaud Fauconnier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charles Chapron
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag London Limited

About this chapter

Cite this chapter

Dubuisson, JB., Fauconnier, A., Chapron, C. (2003). Laparoscopic Myomectomy. In: Ultrasound and Endoscopic Surgery in Obstetrics and Gynaecology. Springer, London. https://doi.org/10.1007/978-1-4471-0655-5_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0655-5_7

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1170-2

  • Online ISBN: 978-1-4471-0655-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation