International Journal of Gynecological Endoscopy

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VOLUME 1 , ISSUE 1 ( January-March, 2017 ) > List of Articles

ORIGINAL ARTICLE

Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy

Sonam Singh

Citation Information : Singh S. Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy. Int J Gynecol Endsc 2017; 1 (1):22-27.

DOI: 10.5005/jp-journals-10058-0005

License: CC BY 3.0

Published Online: 01-03-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

To assess the feasibility and outcome of laparoscopic myomectomy and multiple-layer closure of myoma bed for management of myomas at a tertiary care hospital.

Materials and methods

Five hundred and ten patients from January 2011 to January 2017 with large and moderate size myomas were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. Myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Fluid as adhesion barrier was used.

Results

Three hundred and eighty two patients presented with subfertility, 69 with menorrhagia, and 59 with abdominal mass. The average maximum diameter of myoma was 9.1 cm. The mean duration of surgery was 90 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In seven cases, minilap incision was given for retrieval of myoma and suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during follow-up except one patient who developed omental hernia at morcellator port site. There was no rupture of scar and very low adhesion scores in subsequent cesarean sections or second look scopies.

Conclusion

With proper multilayer closure of the myoma bed, laparoscopic myomectomy is feasible for moderate and even large myomas and has good outcomes in terms of fertility and alleviation of symptoms.

How to cite this article

Jain N, Singh S. Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy. Int J Gynecol Endsc 2017;1(1):22-27.


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