The Indications, Surgical Techniques, and Postoperative Prognosis of Laparoscopic Adenomyomectomy and Hysteroplasty

Abstract

Study Objective: To assess the efficacy and safety of laparoscopic adenomyomectomy.Design: Prospective study.Setting: Univercity-affiliated Hospital.Patients: fifty five women with adenomyosis who desire to conserve.Intervention: 2 methods of Laparoscopic adenomyomectomy and hysteroplasty.; Wedge Resection (WR) and Double Flap method (DF).Measurements and Main Results: Wedge Resection (WR) have been performed for 20 women with adenomyotic nodule s closed to serosal membrane and Double Flap method (DF) have been performed for 35 women with them closed to endometrium. WR is performed by making a V-shaped notch to remove the adenomyotic nodule and surrounding serosa with monopolar needle. Then remained muscle layer is sutured to be performed hysteroplasty. The procedure of DF is that after transverse incision, the adenomyotic nodule was removed remaining of the serosal tissue as the upper and lower flaps, and they were overlapped and sutured. The visual analog scale of dysmenorrhea was significantly decreased after the surgery. Postoperative pregnancy rate was 45.0% (9/20), and there is no severe complication during pregnancy and deliverly.Conclusion: Laparoscopic adenomyomectomy was also found to be safe and useful minimally invasive surgery to conserving fertility. Study Objective: To assess the efficacy and safety of laparoscopic adenomyomectomy. Design: Prospective study. Setting: Univercity-affiliated Hospital. Patients: fifty five women with adenomyosis who desire to conserve. Intervention: 2 methods of Laparoscopic adenomyomectomy and hysteroplasty.; Wedge Resection (WR) and Double Flap method (DF). Measurements and Main Results: Wedge Resection (WR) have been performed for 20 women with adenomyotic nodule s closed to serosal membrane and Double Flap method (DF) have been performed for 35 women with them closed to endometrium. WR is performed by making a V-shaped notch to remove the adenomyotic nodule and surrounding serosa with monopolar needle. Then remained muscle layer is sutured to be performed hysteroplasty. The procedure of DF is that after transverse incision, the adenomyotic nodule was removed remaining of the serosal tissue as the upper and lower flaps, and they were overlapped and sutured. The visual analog scale of dysmenorrhea was significantly decreased after the surgery. Postoperative pregnancy rate was 45.0% (9/20), and there is no severe complication during pregnancy and deliverly. Conclusion: Laparoscopic adenomyomectomy was also found to be safe and useful minimally invasive surgery to conserving fertility.