Laparoendoscopic single-site myomectomy and the use of fibrin sealant (Tisseel)

Publication date: November 2015 Source:Gynecology and Minimally Invasive Therapy, Volume 4, Issue 4 Author(s): Angelito Magno, Hsin-Hong Guo, Chyi-Long Lee Myomectomy remains the standard surgical treatment for women with uterine myoma, who wish to preserve their fertility. However, it is often associated with increased blood loss and adhesion formation. Laparoscopic myomectomy has multiple advantages over open myomectomy 1 . A newer approach, laparoendoscopic single-site surgery, also known as LESS, has been developed and applied in gynecologic field. 2 This is a case of a 41-year-old G2P1 patient, with the complaints of irregular menstrual cycles and lower abdominal pain for 6 months. Transvaginal ultrasound showed uterine myoma at the anterior corpus, measuring 6 × 5 cm2. The procedure is started by grasping the bilateral edges of the umbilicus with Allis forceps. A vertical incision, 1.5–2 cm, is made from the superficial skin of the umbilicus to the ventral peritoneum. A wound retractor of appropriate size is inserted and adjusted. A multiple instrument access port (LagisEndosurgical, Taichung, Taiwan) is placed over the wound retractor (Figure 1). Prior to the procedure, inspection of the pelvic organs is performed to determine the pathology. Vasopressin is injected over the area of the myoma to decrease blood loss. Location of the myoma is then identified. Uterine incision is made on the serosa over the area of the myoma using the monopolar scissors....
Source: Gynecology and Minimally Invasive Therapy - Category: OBGYN Source Type: research