Laparoscopic Myomectomy: Indications and Limits

Czech version

Authors: Z. Holub
Authors‘ workplace: Gynekologicko-porodnické oddělení, Endoskopické výukové centrum, Oblastní nemocnice Kladno, a. s. primář doc. MUDr. Z. Holub, CSc.
Published in: Ceska Gynekol 2007; 72(1): 64-68
Category: Original Article

Overview

Objective:
An analysis of indication and limits of laparoroscopic myomectomy with regard to clinical usefulness.

Design:
A short review article.

Setting:
Department of Obstetrics and Gynecology, Endoscopic Training Centre, Hospital, Kladno, Czech Republic.

Subject and method:
One of the primary goals of laparoscopic myomectomy is preservation of the uterus for the future fertility and psychosomatic integrity of women through minimally invasive way. A comparison is made of advantage and disadvantage of different types of myomectomy.

Conclusion:
Laparoscopic myomectomy is surgical alternative for women with symptomatic subserosal and intramural fibroids. The indication for this technique is limited. Removal of large fibroids and repair of myometrial defect are challenges to gynecologic laparoscopists, and also the main limitations. A well trained laparoscopic surgical team can operate any fibroid. In our experience, as well as reflected by the literature, a consensus gradually emerges that a maximal size of 8-10 cm and a total number of fibroids should not exceed four.

Key words:
laparoscopic myomectomy, subserosal fibroids, untramural fibroids