Mini-Laparotomy Myomectomy: A Minimally Invasive Technique for a 40-Week Size Fibroid Uterus

Abstract

ObjectiveMini-laparotomy myomectomy with morcellation is a safe and efficient alternative for uterine myomectomy of a large 40-week size fibroid uterus in a woman who had yet to complete childbearing.DescriptionThe patient presented in the video is a 38 year old para 1 female with a greater than 40-week fibroid uterus and desired future fertility. The video illustrates the surgical technique of a mini-laparotomy myomectomy. The myomectomy was performed through a 5 cm suprapubic incision at the site of the patient's prior Pfannenstiel incision. The Mobius elastic device was used as a self-retaining abdominal retractor. The myomas were then progressively morcellated using a scalpel in a similar fashion to vaginal morcellation. The endometrial cavity was not entered. The uterus was then repaired in multiple layers using Vicryl suture. The total weight of the uterine fibroids was 3641 gm. The patient conceived and had a successful pregnancy and delivery at term via cesarean section one year after her myomectomy.ConclusionThis case illustrates that mini-laparotomy myomectomy is a safe and effective alternative to standard laparotomy, laparoscopic, or robotic-assisted myomectomy.DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS:Nora Bassiouni: Nothing to discloseJavier F. Magrina: Nothing to disclosePaul Magtibay: Nothing to disclose ObjectiveMini-laparotomy myomectomy with morcellation is a safe and efficient alternative for uterine myomectomy of a large 40-week size fibroid uterus in a woman who had yet to complete childbearing. Mini-laparotomy myomectomy with morcellation is a safe and efficient alternative for uterine myomectomy of a large 40-week size fibroid uterus in a woman who had yet to complete childbearing. DescriptionThe patient presented in the video is a 38 year old para 1 female with a greater than 40-week fibroid uterus and desired future fertility. The video illustrates the surgical technique of a mini-laparotomy myomectomy. The myomectomy was performed through a 5 cm suprapubic incision at the site of the patient's prior Pfannenstiel incision. The Mobius elastic device was used as a self-retaining abdominal retractor. The myomas were then progressively morcellated using a scalpel in a similar fashion to vaginal morcellation. The endometrial cavity was not entered. The uterus was then repaired in multiple layers using Vicryl suture. The total weight of the uterine fibroids was 3641 gm. The patient conceived and had a successful pregnancy and delivery at term via cesarean section one year after her myomectomy. The patient presented in the video is a 38 year old para 1 female with a greater than 40-week fibroid uterus and desired future fertility. The video illustrates the surgical technique of a mini-laparotomy myomectomy. The myomectomy was performed through a 5 cm suprapubic incision at the site of the patient's prior Pfannenstiel incision. The Mobius elastic device was used as a self-retaining abdominal retractor. The myomas were then progressively morcellated using a scalpel in a similar fashion to vaginal morcellation. The endometrial cavity was not entered. The uterus was then repaired in multiple layers using Vicryl suture. The total weight of the uterine fibroids was 3641 gm. The patient conceived and had a successful pregnancy and delivery at term via cesarean section one year after her myomectomy. ConclusionThis case illustrates that mini-laparotomy myomectomy is a safe and effective alternative to standard laparotomy, laparoscopic, or robotic-assisted myomectomy.DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS:Nora Bassiouni: Nothing to discloseJavier F. Magrina: Nothing to disclosePaul Magtibay: Nothing to disclose This case illustrates that mini-laparotomy myomectomy is a safe and effective alternative to standard laparotomy, laparoscopic, or robotic-assisted myomectomy.