Endoscopic Myomectomy Research Articles

A Study on the Impact of Endoscopic Myomectomy on Reproductive Outcomes of Assisted Reproductive Technology

A Study on the Impact of Endoscopic Myomectomy on Reproductive Outcomes of Assisted Reproductive Technology

Transvaginal Natural Orifice Transluminal Endoscopic Myomectomy for Cervical Fibroid

Transvaginal Natural Orifice Transluminal Endoscopic Myomectomy for Cervical Fibroid

A trans-vaginal endoscopic extraperitoneal myomectomy

Trans-vaginal endoscopic extraperitoneal myomectomy is an uncommon minimally invasive surgical procedure. When accessible, a vaginal myomectomy is an interesting approach for patients with para-cervical or cervical fibroids that want a fertility-sparing surgery. A 37-year-old woman nulliparous presents with deep dyspareunia and voiding dysfunction due to a 4 cm para-cervical fibroid. Patient desires to conceive as soon as possible and would like the least invasive surgical approach. After proper counseling, the patient was admitted for trans-vaginal endoscopic myomectomy. A successful vaginal myomectomy was performed with no peri- or post-operative complications. The patient was seen 6 weeks later. Her complaints resolved and she was pleased with the surgical results. She is now seeking fertility treatment. This video shows a trans-vaginal endoscopic extraperitoneal myomectomy. It is a safe and novel surgical technique that can be considered in patients with low lying uterine fibroids accessible vaginally.

The Influence of Intraoperative Ultrasound Monitoring on the Risk of Recurrence and Reoperation in Patients with Hysteromyomectomy.

In recent years, with the continuous development and application of minimally invasive methods in China, laparoscopic myomectomy has become the primary method for clinical treatment of uterine fibroids. There is also a high risk of recurrence and reoperation after endoscopic myomectomy. Intraoperative use of ultrasound for auxiliary examination can provide medical staff with spatial information and position information of fibroids and help medical staff to accurately locate the surgical incision. The aim is to investigate the effect of intraoperative ultrasound monitoring on the risk of postoperative recurrence and reoperation in patients undergoing myomectomy. This study retrospectively collected 80 patients who underwent laparoscopic myomectomy in the gynecology department of our hospital from January 2020 to January 2022. According to the different treatment methods, they were divided into a study group and a control group (both n = 40). The control group underwent preoperative ultrasonography and then underwent myomectomy, while the study group underwent both preoperative and intraoperative ultrasonography before undergoing hysterectomy. Myomectomy: all the enrolled patients were followed up by ultrasound after surgery and followed up for 1 year (recheck ultrasound every 3 months). The indicators, postoperative complications, postoperative average diameter of uterine fibroids, postoperative residual rate of uterine fibroids, postoperative recurrence, and reoperation were compared between the two groups. Intraoperative ultrasound monitoring has a significant effect on patients undergoing myomectomy, which can effectively reduce the residual rate of fibroids, completely remove small and deep fibroids, and reduce complications, postoperative recurrence, and reoperation risks. It has good clinical application value.

Features of regional blood flow after endoscopic myomectomy

The state of regional blood flow in 65 patients before and after endoscopic myomectomy was studied using modem methods such as Doppler examination and color Doppler sonography. It was determined that blood flow velocity indeces obtained during the Doppler examination of myoma vessels and uterine arteries allow to estimate the morphological structure of myomas uninvasively and can be used to define the indications for conservative endoscopic surgical procedures in patients with myoma uteri. Doppler monitoring of regional blood flow during postoperative period makes it possible to evaluate the effectiveness of surgical treatment previously performed.

Combined myomectomy and uterine artery embolization

Objective: To evaluate the safety and efficacy of uterine artery embolization combined with endoscopic myomectomy. Material and methods: We conducted a retrospective chart review of patients (n = 125) who underwent myomectomy concurrent with embolization within one month. We assessed two groups: 1) uterine artery embolization followed by hysteroscopic myomectomy and 2) uterine artery embolization followed by laparoscopic myomectomy. Results: Following the combination procedures, 72% of the surveyed women reported symptom improvement. With the combined procedures, 92.5% of patients experienced reduction in myoma diameter and 87.5% of patients had decreased uterine size after an average of 4.70 months post subsequent procedure. The amount of decrease in the uterine volume (p = 0.39) and fibroid size (p = 0.23) were not significant between the two endoscopic myomectomy groups. Conclusions: Combining myomectomy with uterine artery embolization is a safe and effective procedure in treating symptoms and reducing myoma and uterine volumes.

Extreme hyponatremia with moderate metabolic acidosis during hysteroscopic myomectomy -A case report-.

Excess absorption of fluid distention media remains an unpredictable complication of operative hysteroscopy and may lead to lethal conditions. We report an extreme hyponatremia, caused by using an electrolyte-free 5 : 1 sorbitol/mannitol solution as distention/irrigation fluid for hysteroscopic myomectomy. A 34-year-old female developed severe pulmonary edema and extreme hyponatremia (83 mmol/L) during transcervical endoscopic myomectomy. A brain computed tomography showed mild brain swelling without pontine myelinolysis. The patient almost fully recovered in two days. Meticulous attention should be paid to intraoperative massive absorption of fluid distention media, even during a simple hysteroscopic procedure.

355: Seeding and Growing of Uterine Leiomyoma Particle in an Abdominal Wall After Endoscopic Myomectomy

The particles of uterine leiomyomas can be seeded and grow in the abdominal-wall after endoscopic myomectomy and cannot be identified during the procedure. The objective of this study is to report such a complication after endoscopic myomectomy.

Incidence of adhesions after endoscopic myomectomy - interceed TC7 versus intergel

International Journal of Gynecology & ObstetricsVolume 70, Issue S5 p. E25-E25 Free communication Laparoscopic surgery: techniques Incidence of adhesions after endoscopic myomectomy - interceed TC7 versus intergel M. Korell, M. KorellSearch for more papers by this authorN.v. Obernitz, N.v. ObernitzSearch for more papers by this authorH. Hepp, H. HeppSearch for more papers by this author M. Korell, M. KorellSearch for more papers by this authorN.v. Obernitz, N.v. ObernitzSearch for more papers by this authorH. Hepp, H. HeppSearch for more papers by this author First published: 11 December 2003 https://doi.org/10.1016/S0020-7292(00)82413-3Citations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume70, IssueS52000Pages E25-E25 RelatedInformation

6 Gonadotrophin hormone-releasing hormone analogue treatment of fibroids

Gonadotrophin hormone-releasing hormone analogue (GnRHa) therapy can induce a reduction in fibroid volume by up to 50% over a period of 3 months treatment. This effect may be beneficial in selected patients, prior to open or endoscopic myomectomy, to aid the surgical procedure by improving vision because of reduced blood loss and reduced uterine artery blood flow. Symptoms of excessive menstrual bleeding, pelvic pain and dysmenorrhoea will also be controlled. Long-term administration of GnRHa requires the use of concomitant add-back therapy, the optimal combination investigated to date being an oestrogen-progestogen continuous combined preparation.

Enucleation of 482 myomectomies

Of more than 800 women with uterine myomas, 60% underwent endoscopic myomectomy with uterine preservation and 40% conventional hysterectomy. Before endoscopic myomectomy, 3% of women were treated with gonadotropin-releasing hormone analogs for 3 to 6 months. Operating time was 30 to 60 minutes. No complications occurred. Histologically, the majority of myomas were fibromyomas.