Minimally invasive surgery for 697 cases with uterine myoma

Objective:To assess the application and value of minimally invasive myomectomy for the treatment of uterine myoma. Methods: 115 cases of uterine myoma were performed by transcervical resection of myoma(TCRM) under hysteroscope, 5 cases were performed by total laparoscopic hysterectomy(TLH) ,58 cases were performed by laparoscopic hysterectomy(LH)), 153 cases were performed by classical intrafascial supracervical hysterectomy(CISH), 8 cases were performed by laparoscopic supracervical hysterectomy(LSH) ,36 cases were performed by laparoscopiclly assisted vaginal hysterectomy(LAVH) , 156 cases were performed by laparoscopic hystero-myomectomy(LM)and 166 cases were performed by total vaginal hysterectomy(TVH) .Results: All were successfully operated.Conclusions:TCRM is mainly applicable to submucous myoma and to some intramural myoma. LM is mainly applicable to cases of myoma removed while keeping the uterus. CISH is especially ideal for young patients. But for patients with Ⅲ erosion of cervix and CIN patients, LAVH,LH, TLH or TVH is more effective. TVH is applicable to patients with Ⅲ erosion of cervix and CIN, especially to those with bysteroptosis, stress urinary incontinence and adenomyosis. LAVH is applicable to patients with pelvic adhesion.