Laparoscopic adenomyomectomy and hysteroplasty: A novel method

Takeuchi H, Hiroyuki Takeuchi, Kitade M, Mari Kitade, Iwaho Kikuchi, Shimanuki H, Hiroto Shimanuki, Jun Kumakiri, Kumakiri J, Kitano T, Takamitsu Kitano, Kinoshita K, Katsuyuki Kinoshita
Journal of Minimally Invasive Gynecology · 2006 · vol. 13(2) , pp. 150–154 · doi:10.1016/j.jmig.2005.12.004 · PMID:16527719 · W2117536709
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This paper describes a novel laparoscopic technique combining adenomyomectomy and hysteroplasty for treating adenomyosis.

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Abstract

Study objectiveTo evaluate a novel method of laparoscopic adenomyomectomy.DesignProspective study (Canadian Task Force classification II-3).SettingUniversity-affiliated hospital.PatientsFourteen women with adenomyosis.InterventionLaparoscopic adenomyomectomy and hysteroplasty. After local injection by diluted vasopressin solution, a transverse incision was made in the adenomyotic tissue down to the endometrium, and the adenomyotic tissue was surgically removed with a monopolar needle. The normal muscle layer on the serosal membrane side was left as an upper and lower serosal flap. The flaps were overlapped and sutured to counteract the lost muscle layer to reconstruct the uterus. MEASUREMENTS AND MAIN OUTCOME: The changes of symptoms were evaluated before and after the operation. The visual analog scale of dysmenorrhea was significantly decreased, and hypermenorrhea was improved after the surgery. Postoperative pregnancy was achieved in 2 patients, and vaginal delivery was performed in the first case.ConclusionFor specific cases, laparoscopic adenomyomectomy may be a suitable method to relieve symptoms with minimally invasive surgery while conserving the uteri.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Hysteroscopes Hysteroscopy Uterine Diseases Adult Endometriosis Endometriosis Female Follow-Up Studies Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Hysteroscopy Magnetic Resonance Imaging Minimally Invasive Surgical Procedures Minimally Invasive Surgical Procedures Prospective Studies Risk Assessment Severity of Illness Index Treatment Outcome

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