Prevention and Management of Complications in Laparoscopic Myomectomy

Vasilios Tanos, Kelsey Elizabeth Berry, K E Berry, Michael Frist, M Frist, R Campo, R L DeWilde, Rudi Leon DeWilde
BioMed research international · 2018 · vol. 2018 , pp. 1–9 · doi:10.1155/2018/8250952 · PMID:29693017 · PMC5859837 · W2791285653
review OA: gold CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Laparoscopic myomectomy preserves fertility and treats symptoms while minimizing complications such as bleeding, adhesions, and recurrence through careful surgical technique, imaging, and port placement.

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Abstract

Myomectomy aims to preserve fertility, treat abnormal uterine bleeding, and alleviate pain. It should cause minimal damage to the endometrium, while being tolerable and durable, and reduce the incidence of myoma recurrence and complications including bleeding, hematoma, adhesions, and gravid uterus perforation. Training and experience are crucial to reduce complications. The surgical strategy depends on imaging information on the myomas. The position of the optical and secondary ports will determine the degree of ergonomic surgery performance, time and difficulty of myoma enucleation, and the suturing quality. Appropriate hysterotomy length relative to myoma size can decrease bleeding, coagulation, and suturing times. Bipolar coagulation of large vessels, while avoiding carbonization and myometrium gaps after suturing, may decrease the risk of myometrial hematoma. Quality surgery and the use of antiadhesive barriers may reduce the risk of postoperative adhesions. Slow rotation of the beveled morcellator and good control of the bag could reduce de novo myoma and endometriosis. Low intra-abdominal CO 2 pressure may reduce the risk of benign and malignant cell dissemination. The benefits a patient gains from laparoscopic myomectomy are greater than the complication risks of laparoscopic morcellation. Recent publications on laparoscopic myomectomies demonstrate reduced hospitalization stays, postoperative pain, blood loss, and recovery compared to open surgery.

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Condition tags

endometriosis

MeSH descriptors

Laparoscopy Postoperative Complications Uterine Myomectomy Humans Laparoscopy Length of Stay Myoma Myoma Myoma Postoperative Complications Postoperative Complications Risk Uterine Myomectomy

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Cited by (6)

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