Myoma Uteri

myomauteri-1-0-25kapak

Laparoscopic Myomectomy

Emre Erdem Taş

Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Gynecology and Obstetric, Ankara, Türkiye

Taş EE. Laparoscopic Myomectomy. Yavuz AF, ed. Myoma Uteri. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.91-96.

ABSTRACT

Laparoscopic myomectomy (LM) is a minimally invasive surgical procedure for the treatment of uter- ine fibroids, the most prevalent pelvic tumor in women of reproductive age. LM offers advantages over traditional open myomectomy, including shorter hospital stays, faster recovery, less postoperative pain, fever, hemoglobin drop, and reduced adhesion formation. Patient selection for LM depends on the location, size, and number of fibroids, with relative contraindications including diffuse leiomyomata, multiple large fibroids, and uterine size greater than 20 weeks of gestation. Preoperative considerations included general investigations, diagnostic imaging, exclusion of occult malignancies, and comprehen- sive patient counseling. The surgical principles of LM are similar to those of other pelvic laparoscopic surgical techniques. Minimizing blood loss is crucial, and surgeons utilize pharmacological and pro- cedural methods, such as vasopressin, oxytocin, tranexamic acid, and uterine artery occlusion. Precise dissection, identification of the fibroid pseudocapsule, and multilayer closure of the myometrium are essential for a successful LM. Extraction of fibroids is achieved using a morcellator, posterior colpot- omy, or mini-laparotomy, with caution because of the risk of spreading occult leiomyosarcoma. LM is a challenging but effective procedure for the treatment of uterine fibroids, offering numerous benefits over traditional open surgery.

Keywords: Myoma; Minimally invasive surgery; Laparoscopy

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