Abstract:

Objective To study the feasibility and safety of laparoscopic excision of large and multi-hysteromyoma.Methods To evaluate the location,size and the number of myoma by ultrasound preoperation.The amount of hemorrhage was evaluated by volume.Surgical technique: To cut through the envelope of the myoma,resect myoma,and suture the uterus wall.Followed the patients regularly.Results 102 patients were evaluated.There were 33 multi-myoma and 69 mono-myoma.There were 29 cases of intramural myoma,including 13 mono-myoma,with maximum tumor size in diameter 5～12 cm,mean(7.6±2.0)cm;16 multi-myoma,the number of myoma was 2～14,mean(4.9),with maximum tumor size in diameter 3～8.5 cm,mean(5.2±(1.5))cm.There were 61 subserous myoma,44 mono with maximum tumor size in diameter 6～15 cm,mean(8.2±2.5) cm,17 multiple,the number of myoma was 2～14,mean 4.0 with maximum tumor size in diameter 2～10 cm,mean(4.9±2.1)cm;8 intra-broad ligament,with maximum tumor size in diameter 7～12 cm,mean(8.1±0.9)cm.4 submucous,maximum tumor size in diameter 8～10 cm,mean(8.7±0.5)cm.The outcome of operation: 101 cases of laparoscopic myomectomy were performed and 1 cases of mini-abdominal incision myomectomy with assisted laparoscopy no alternative to laparotomy,no case changed to total hysterectomy.Duration of operation: 30～240 min,mean(87.2 ±43.1)min.Blood loss during the operation: 5～400 mL,mean(53.6±56.6)mL.Short term effectiveness: Complete resection 100 cases,nearly complete resection 2 cases,partial resection 0.Complications: pneumoderma 3 cases,hemorrhage post-operation 0 case,subcutaneous hematoma 1 case,infection 1 case.Conclusion Laparoscopic resection of the large and multi-myoma is feasible and safe.The OBGY doctors should pay more attention to the indications of laparoscopic hysteromyomectomy.

Key words: uterine myoma, laparoscope, surgical procedure