IMR Press / CEOG / Volume 29 / Issue 4 / pii/2002070

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Laparoscopic-ultraminilaparotomic myomectomy (LUM)­ laparoscopic-ultraminilaparotomic embolized myomectomy (LUEM). Surgical techniques 

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1 Dept. of Obstetrics and Gynecology, San Filippo Neri Hospital, Rome (Italy)
Clin. Exp. Obstet. Gynecol. 2002, 29(4), 277–280;
Published: 10 December 2002
Abstract

Laparoscopic myomectomy has been performed for more than 20 years. More recently other techniques such as laparoscopically assisted vaginal myomectomy (LAVM) and laparoscopically assisted myomectomy (LAM) have also been introduced. Laparoscopic-ultraminilaparotomic myomectomy (LUM) and laparoscopic-ultraminilaparotomic embolized myomectomy (LUEM), a new surgical technique which integrates laparoscopy and ultraminilaparotomy and embolization, has been created by our group and has been found to be superior to the conventional laparoscopy for the treatment of uterine fibromas especially in large myomas > 9 cm. This technique allows us to apply a suture on the uterine incision totally similar to the suture of a conventional laparotomy, by using the small breach of the cutaneous incision of the uterine morcellator (25 mm) and drawing the uterus below this abdominal aperture. This kind of surgical procedure is associated with presurgical embolization, that we call LUEM (laparoscopic ultraminilaparotomic embolized myomectomy) of the afferent vessels to the myoma in myomas with diameters equal or superior to 14 cm to avoid blood loss during the surgical procedure. Between June 1999 and March 2002, a total of 62 patients wishing to become pregnant were treated with this method. LUM allows us to increase the feasibility and safety of the operation, while assuring a better stability of the uterine suture and reduction of surgical time. LUEM has the advantages of LUM but permits in an absolutely hemostatic situation the application of laparoscopy in the surgery of large myomas superior to 14 cm.

Keywords
Laparoscopy
Myomectomy
Laparoscopic myomectomy
Embolization
Minilaparotomy
Uterine suture
Rupture of uterus
Pregnancy
Hemostasis
Morcellation
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