(1) Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, 00168 Rome, Italy
(2) Centre for Reproduction, Department of Obstetrics and Gynaecology, Uppsala University Hospital, 751 85 Uppsala, Sweden
The Authors describe a novel technique for laparoscopic myomectomy of fibroids with a subserosal component which involves the use of endoscopic loops under progressive tension to avoid bleeding, facilitate enucleation and possibly reduce the need of conventional sutures. Data analysis from a series of 34 consecutive operations shows that the use of endoloops helps achieving a good haemostasis, and no case of haemorrhage from the fibroid bed was ever recorded. Moreover, the need of diathermy was reduced, and the enucleation of the fibroids resulted facilitated by a bloodless field and the squeezing effect induced by the progressive tension on the loops. Although a reduction of number of traditional suturing was recorded, we do not recommend this technique to surgeons who are not familiar with conventional laparoscopic suturing. Overall, the suggested use of endoscopic loops seems to facilitate laparoscopic myomectomy on fibroids with at least a partial subserosal component. We believe that this method deserves comparative studies in order to furtherly demonstrate its safety and efficacy.
Keywords Laparoscopy – Myomectomy – Uterine fibroids – Surgical techniques – Endoscopic loops – Conservative treatment
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