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| Name | laparoscopic myomectomy of 15 cm large myoma (fibroid) |
| Video Uploader | Video From Dr. Andreas Kavallaris |
| Upload Date | This Video Uploaded At 21-11-2021 15:33:40 |
| Video Discription | Uterine leiomyoma is the most common benign tumour occurring in women in the reproductive age. It is typically found during the middle and later reproductive years. The prevalence quoted in literature ranges from 20-50% based on post mortem studies. The symptoms usually reported by women with fibroids are the following: abnormal gynaecologic haemorrhage, chronic pelvic pain, dyspareunia, as well as urinary and bowel symptoms, urinary frequency or retention and, in some cases, infertility. During pregnancy, premature labor might be caused, interfering with the position of the fetus or abortion could be induced. However, only 30% of the women develop symptoms, most of them being asymptomatic. It wasroved that the factors that can cause fibroids are the following: genetic, hormonal, and growth factors, especially transforming the growth factor beta (TGFb)-related cellular changes. As diagnosis tools, studies are revealing that ultrasound has been shown to be less nsufficient method of myoma mapping, and magnetic resonance imaging should be preferred for surgical therapy planning. The contour of the endometrial cavity is delineated by using trans vaginal ultrasound and saline infusion hysterosonography, but hysteroscopy is the gold standard to evaluate the uterine cavity. Laparoscopic myomectomy was first described in 1979 (for subserosal fibroids) and in the early '90s, the procedure started to be used also for intramural myomas also. Nowadays, laparoscopic myomectomy is one of the common surgical procedures in infertile patients. The gold standard access for myomectomy is laparoscopy in selected cases, including intramural and sub-serous symptomatic leiomyomas. The main contraindications concern inexperience of the surgeon, severe necrobiosis, suspected leiomyosarcoma and excessive size. References: 1. Dubuisson JB, O'Leary T, Feki A, Bouquet DE Jolinière J, Dubuisson J. Laparoscopic myomectomy. Minerva Ginecol. 2016 Jun;68(3):345-51. Epub 2016 Feb 29. PMID: 26928417. 2. Naval S, Naval R, Naval S, Rane J. Tips for Safe Laparoscopic Multiple Myomectomy. J Minim Invasive Gynecol. 2017 Feb;24(2):193. doi: 10.1016/j.jmig.2016.07.012. Epub 2016 Jul 20. PMID: 27449692. 3. Stoica RA, Bistriceanu I, Sima R, Iordache N. Laparoscopic myomectomy. J Med Life. 2014 Oct-Dec;7(4):522-4. PMID: 25713613; PMCID: PMC4316130. Dr. med. A. Kavallaris Gynegologist Oncologist, Pelvic Surgeon |
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