Skip to main content
Log in

Isobaric gasless laparoscopic myomectomy for removal of large uterine leiomyomas

  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

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.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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

    Google Scholar 

  2. 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

    Article  PubMed  CAS  Google Scholar 

  3. Banting S, Shimi S, Vander Velpen G, Cuschieri A (1993) Abdominal wall-lift: low-pressure pneumoperitoneum laparoscopic surgery. Surg Endosc 7: 57–59

    Article  PubMed  CAS  Google Scholar 

  4. Brams DM, Cardoza M, Smith RS (1993) Laparoscopic repair of traumatic gastric perforation using a gasless technique. J Laparoendosc Surg 3: 587–591

    PubMed  CAS  Google Scholar 

  5. 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

    PubMed  CAS  Google Scholar 

  6. 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

    PubMed  Google Scholar 

  7. Daraï E, Deval B, Darles C, Benifla JL, Guglielmina JN, Madelenat P (1996) Myomectomie: coelioscopie où laparotomie. Contracept Fertil Sex 24: 751–756

    PubMed  Google Scholar 

  8. Dubuisson JB, Chapron C (1996) Laparoscopic myomectomy today: a good technique when correctly indicated. Hum Reprod 11: 934–935

    PubMed  CAS  Google Scholar 

  9. Dubuisson J-B, Fauconnier A, Babaki-Fard K, Chapron C (2000) Laparoscopic myomectomy: a current view. Hum Reprod Update 6: 588–594

    Article  Google Scholar 

  10. Dubuisson J-B, Fauconnier A, Chapron C, Kreiker G, Norgaard C (1998) Second look after laparoscopic myomectomy. Hum Reprod 13: 2102–2106

    Article  PubMed  CAS  Google Scholar 

  11. 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

    Article  PubMed  CAS  Google Scholar 

  12. Gazayerli MM (1991) The Gazayerli endoscopic retractor model 1. Surg Laparosc Endosc 1: 98–100

    PubMed  CAS  Google Scholar 

  13. 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

    Article  PubMed  CAS  Google Scholar 

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. 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

    Article  PubMed  CAS  Google Scholar 

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

    Google Scholar 

  17. 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

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  19. Ribeiro SC, Reich H, Rosenberg J, Guglielminetti E, Vidali A (1999) Laparoscopic myomectomy and pregnancy outcome in infertile patients. Fertil Steril 71: 571–574

    Article  PubMed  CAS  Google Scholar 

  20. Rossetti A, Sizzi O, Scranna L, Mancuso S, Lanzone A (2001) Fertility outcome: long-term results after laparoscopic myomectomy. Gynecol Endocrinol 15: 129–134

    PubMed  CAS  Google Scholar 

  21. Seinera P, Arisio R, Decko A, Farina C, Crana F (1997) Laparoscopic myomectomy: indications, surgical technique, and complications. Hum Reprod 12: 1927–1930

    Article  PubMed  CAS  Google Scholar 

  22. 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

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  24. 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

    Article  PubMed  CAS  Google Scholar 

  25. Weaver DW (1994) Gasless laparoscopy for complex surgical procedures. Int Surg 79: 314–316

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F. Sesti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-004-9078-4

Keywords

Navigation