2009년 유럽불임학회(ESHRE) P-589 Rapid and secure laparoscopic myomectomy: laparoscopic myomectomy with morcellation and suture by ultraminilaparotomy - a prospective study. (자궁근종 적출술 – 빠르고 안전한 수술과 최소복부 절개술을 통한 결과 분석)

K.H. Lee1, I.H. Park1
1Mamapapa&baby Infertility Clinics, Obstetrics & Gynecology, Ulsan, Korea South

Introduction

Laparoscopic myomectomy is a good minimally invasive surgery for management of myomas. However, it needs a lot of surgical technique and experience especially in suturing uterine incisions. Also large myoma morcellation process need much time. So our clinic introduces a new method of myomectomy. After myoma enucleation by laparoscope, morcellation and suture were performed by Ultraminilaparotomic suprapubic skin incision of 2.5-3 cm in length.

OBJECTIVE

The purpose of this study was to compare intraoperative and shortterm outcomes between laparoscopic myomectomy with morcellation and uterine suture by Ultraminilaparotomy(LMU) and conventional laparoscopic myomectomy(LM) for management of uterine myomas.

MATERIALS AND METHODS

Sixty-eight women with symptomatic uterine myoma who underwent surgical treatment and wished to retain their uterus were prospectively collected in a study period from March 2003 to December 2008. 47 women underwent laparoscopic myomectomy (LM) and 21 women underwent laparoscopic myomectomy with morcellation and uterine suture by Ultraminilaparotomy (LMU). Operation times, intraoperative blood loss, variation in hemoglobin level, hospitalization, vials of analgesic used were evaluated.

RESULTS

The patient’s characteristics by age, parity, body mass index, number, size and location of myoma were well balanced between 2 study groups. The mean operation time was significantly shorter in the LMU group (85±25.3) than LM group (104±27.5) (p<0.01). Intraoperative blood loss, variation in hemoglobin level, hospitalization, vials of analgesic used were similar between the 2 study groups.

CONCLUSION

Laparoscopic myomectomy with morcellation and uterine suture by Ultraminilaparotomy(LMU) is more rapid and easier modality than conventional LM. It probably makes reattach firmly the uterine edge after laparoscopic myomectomy. LMU is rapid and secure myomectomy and can be feasible alternative of LM.