Myoma Uteri

myomauteri-1-0-25kapak

Myomectomy

Fatma Betül Avşar

Ankara Etlik City Hospital, Department of Gynecology and Obstetrics, Ankara, Türkiye

Avşar FB. Myomectomy. Yavuz AF, ed. Myoma Uteri. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.71-76.

ABSTRACT

Uterine fibroids (UF) are the commonest benign tumor of the female genital tract with the prevalence of approximately 80%. Uterine fibroids are the first indication for hysterectomy, but in most cases myo- mectomy is more suitable surgical option for women who desire preservation of their fertility potential. Minimally invasive approaches are preferred, if feasible. While abdominal (laparotomic) myomectomy tend to be recommended for patients who have larger uterine volume and multiple UF, laparoscopic myomectomy is recommended for women with smaller uterine volume and subserosal/ intramural UF. Recognizing and dissecting in the correct plane beneath the capsule in addition to securing the blood vessels as they are encountered during dissection are the most critical steps to minimize blood loss during a myomectomy. If excessive bleeding continues despite the best technique, tourniquet application at the level of the uterine artery entry into the uterus, ligation/clipping/coagulation of the uterine arteries, or temporary clamping of the uterine arteries may be applied to minimize bleeding. If bleeding cannot be stopped during myomectomy despite the surgeon’s best efforts, hysterectomy is the last option.

Keywords: Uterine myomectomy; Leiomyoma; Laparotomy

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