Minilaparoscopic myomectomy: a mini-invasive technical variant

J Laparoendosc Adv Surg Tech A. 2013 Oct;23(10):871-5. doi: 10.1089/lap.2013.0037. Epub 2013 Aug 31.

Abstract

Objective: We propose a mini-invasive technical variant for laparoscopic myomectomy, which is currently less invasive and more feasible.

Study design: This was a prospective, controlled, randomized trial, involving 170 patients, who underwent laparoscopic myomectomy. Patients were randomized into two groups: Group A (n=98) underwent standard laparoscopic myomectomy, and Group B (n=72) underwent the mini-invasive technique. The current mini-invasive variant is performed with a 10-mm umbilical trocar and only two 5-mm ancillary trocars. Morcellation is transumbilical: a 0° 5-mm optical system is used and is inserted either in the left or in the right iliac trocar according to the surgeon's preference.

Results: The degree of surgical difficulty, evaluated using a visual analog scale (VAS), was similar in the two groups (P=nonsignificant). Postoperative pain measured on a VAS scale showed there was less pain experienced in patients in Group B than in Group A (P<.01). Esthetic results measured on a VAS scale showed a higher compliance for patients in Group B than Group A (P<.01).

Conclusions: The mini-invasive laparoscopic myomectomy described is, in our opinion, currently less invasive and more feasible than techniques usually used. Finally, this technique is a valid approach for the surgeon, and it gives women very acceptable aesthetic results.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Leiomyoma / surgery*
  • Operative Time
  • Pain, Postoperative / epidemiology*
  • Patient Satisfaction
  • Prospective Studies
  • Treatment Outcome
  • Uterine Myomectomy / adverse effects
  • Uterine Myomectomy / methods*
  • Uterine Neoplasms / surgery*