Laparoscopic myomectomy and use of electromechanical morcellator: clinical results in a series of cases

• Published in: Ginecologia y obstetricia de Mexico Vol. 83; no. 9; pp. 529 - 536
• Main Authors: Morgan-Ortiz, Fred, Soto-Pineda, Juan Manuel, Alejandro Castro-Ibarra, Morgan-Ruiz, Fred V, Alvear, Humberto Lelevier-de Doig, Báez-Barraza, Josefina
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.09.2015
• Subjects: Adult; Electrosurgery - instrumentation; Female; Gynecologic Surgical Procedures - instrumentation; Gynecologic Surgical Procedures - methods; Humans; Laparoscopy; Leiomyoma - surgery; Retrospective Studies; Uterine Neoplasms - surgery
• ISSN: 0300-9041

to describe the clinical and operative characteristics of patients undergoing laparoscopic myomectomy and use of electromechanical morcellator for removal of tissue. An observational, descriptive and retrospective study was done with the medical records of 65 patients that underwent laparoscopic myomectomy from July 2008 to July 2013. The clinical outcomes, including body mass index (BMI), pregnancies number, parity, previous abortions, indication of myomectomy, surgical findings, length of the procedure, operative bleeding, entry into the endometrial cavity, operative complications and conversion rate to laparotomy were collected and analyzed. The mean age and BMI of the patients were 33.1 years and 26.1 kg/m2, respectively. 64% of patients did not have any pregnancy and 33% had a history of one or more abortions. The most frequent indications for myomectomy were infertility (40%) and abnormal uterine bleeding (53%). The most frequent location of the fibroids was the intramural fundal (46%), with an average size of 6.5 cm (SD ± 3.6). The number of myomas extracted ranged from 1 to 6. The mean operative time was 107.8 min (SD ± 27.5) and the operative bleeding was 145.4 mL (SD ± 42.2). There were no operative complications. The conversion rate to laparotomy was 2%. Power morcellation was used in all cases without complications. Laparoscopic myomectomy with electromechanical morcellator for tissue extraction in low risk patients for malignancy is a feasible procedure with a low conversion rate, minimal operative bleeding and the operative time similar to that reported for myomectomy performed by laparotomy.