Abstract
Background
This study aimed to evaluate the feasibility and safety of isobaric laparoscopic removal of large myomas (≥8 cm) using the Laparotenser, a subcutaneous abdominal wall-lifting system.
Methods
A series of 63 consecutive patients with at least one large symptomatic subserosal or intramural uterine myoma (≥8 cm) underwent an isobaric gasless laparoscopic myomectomy. Conventional laparotomy instruments were used.
Results
The procedure was successfully completed for all 63 consecutive patients. The average size of the dominant myoma was 11 cm. The mean number of myomas removed from each patient was 3.6. The mean blood loss was 143 ml, and the mean operating time was 72 min. No intraoperative complication occurred.
Conclusions
Gasless laparoscopic myomectomy for the removal of large myomas using the Laparotenser is feasible and safe. It offers several advantages over laparoscopy with pneumoperitoneum.
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References
Adamian LV, Kulakov VI VI, Kiselev SI, Murashko AV (1996) Laparoscopic myomectomy in treatment of large myomas. J Am Assoc Gynecol Laparosc 3(4, Suppl): S1
Angelini L, Lirici MM, Papaspyropoulos V, Sossi FL (1997) Combination of subcutaneous abdominal wall retraction and optical trocar to minimize pneumoperitoneum-related effects and needle and trocar injuries in laparoscopic surgery. Surg Endosc 11: 1006–1009
Banting S, Shimi S, Vander Velpen G, Cuschieri A (1993) Abdominal wall-lift: low-pressure pneumoperitoneum laparoscopic surgery. Surg Endosc 7: 57–59
Brams DM, Cardoza M, Smith RS (1993) Laparoscopic repair of traumatic gastric perforation using a gasless technique. J Laparoendosc Surg 3: 587–591
Chang FH, Soong YK, Cheng PJ, Lee CL, Lai YM, Wang HS, Chou HH (1996) Laparoscopic myomectomy of large symptomatic leiomyoma using airlift gasless laparoscopy: a preliminary report. Hum Reprod 11: 1427–1432
Damiani A, Melgrati L, Marziali M, Sesti F (2003) Gasless laparoscopic myomectomy: indications, surgical technique, and advantages of a new procedure for removing uterine leiomyomas. J Reprod Med 48: 792–798
Daraï E, Deval B, Darles C, Benifla JL, Guglielmina JN, Madelenat P (1996) Myomectomie: coelioscopie où laparotomie. Contracept Fertil Sex 24: 751–756
Dubuisson JB, Chapron C (1996) Laparoscopic myomectomy today: a good technique when correctly indicated. Hum Reprod 11: 934–935
Dubuisson J-B, Fauconnier A, Babaki-Fard K, Chapron C (2000) Laparoscopic myomectomy: a current view. Hum Reprod Update 6: 588–594
Dubuisson J-B, Fauconnier A, Chapron C, Kreiker G, Norgaard C (1998) Second look after laparoscopic myomectomy. Hum Reprod 13: 2102–2106
Dubuisson J-B, Fauconnier A, Deffarges J-V, Norgaard C, Kreiker G, Chapron C (2000) Pregnancy outcome and deliveries following laparoscopic myomectomy. Hum Reprod 15: 869–873
Gazayerli MM (1991) The Gazayerli endoscopic retractor model 1. Surg Laparosc Endosc 1: 98–100
Hashimoto D, Nayeem SA, Kajiwara S, Hoshino T (1993) Abdominal wall-lifting with subcutaneous wiring: an experience of 50 cases of laparoscopic cholecystectomy without pneumoperitoneum. Surg Today 23: 786–790
Landi S, Zoccoletti R, Ferrari L, Minelli L (2001) Laparoscopic myomectomy: technique, complications, and ultrasound scan evaluations. J Am Assoc Gynecol Laparosc 8: 231–240
Mais V, Ajossa S, Guerriero S, Mascia M, Solla E, Melis GB (1996) Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol 174: 654–658
Mettler L, Alvarez-Rodas E, Semm K (1995) Myomectomy by laparoscopy: a report of 482 cases. Gynaecol Endosc 4: 259–264
Nezhat C, Nezhat F, Bess O, Nezhat CH, Mashiach R (1994) Laparoscopically assisted myomectomy: a report of a new technique in 57 cases. Int J Fertil Menopausal Stud 39: 39–44
Reich H (1995) Laparoscopic myomectomy. Obstet Gynecol Clin North Am 22: 757–780
Ribeiro SC, Reich H, Rosenberg J, Guglielminetti E, Vidali A (1999) Laparoscopic myomectomy and pregnancy outcome in infertile patients. Fertil Steril 71: 571–574
Rossetti A, Sizzi O, Scranna L, Mancuso S, Lanzone A (2001) Fertility outcome: long-term results after laparoscopic myomectomy. Gynecol Endocrinol 15: 129–134
Seinera P, Arisio R, Decko A, Farina C, Crana F (1997) Laparoscopic myomectomy: indications, surgical technique, and complications. Hum Reprod 12: 1927–1930
Smith RS, Fry WR, Tsoi EK, Henderson VJ, Hirvela ER, Koehler RH, Brams DM, Morabito DJ, Peskin GW (1993) Gasless laparoscopy and conventional instruments: the next phase of minimally invasive surgery. Arch Surg 128: 1102–1107
Stringer NH (1996) Laparoscopic myomectomy in African American women. J Am Assoc Gynecol Laparosc 3: 375–381
Vezakis A, Davides D, Gibson JS, Moore MR, Shah H, Larvin M, McMahon MJ (1999) Randomized comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. Surg Endosc 13: 890–893
Weaver DW (1994) Gasless laparoscopy for complex surgical procedures. Int Surg 79: 314–316
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Damiani, A., Melgrati, L., Franzoni, G. et al. Isobaric gasless laparoscopic myomectomy for removal of large uterine leiomyomas. Surg Endosc 20, 1406–1409 (2006). https://doi.org/10.1007/s00464-004-9078-4
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DOI: https://doi.org/10.1007/s00464-004-9078-4