手術手技
びまん性子宮平滑筋腫症に対する腹腔鏡補助下筋腫核出術の工夫
キーワード:
diffuse uterine leiomyomatosis,
laparoscopically assisted myomectomy,
temporary uterine artery clipping
2020 年 36 巻 1 号 p. 213-219
詳細
2020 年 36 巻 1 号 p. 213-219
Objective: To assess the effects of the laparoscopically assisted myomectomy (LAM) procedure that we added to a previously reported technique for diffuse uterine leiomyomatosis.
Methods: In the previous technique, a longitudinal dissection was made at the midline of the uterus, and then the uterine wall was divided into two from the dissection site to effectively enucleate the myomas near the endometrium. We performed this technique after clipping the uterine artery temporarily under laparoscopy to reduce blood loss. Moreover, we did not use an energy device for enucleation near the endometrium to prevent heat damage.
Results: We performed this operation in two patients, with blood losses of 693 and 180 g and operation times of 334 and 327 minutes, respectively. Their intraoperative and postoperative courses were uneventful. One patient gave birth to a healthy baby. The other patient showed an improvement for hypermenorrhea.
Conclusion: The procedure we added to the previous technique was safe and effective. Further studies involving more patients are needed to examine pregnancy or menstrual outcomes.
