Bulut VARLI, Şahin Kaan BAYDEMİR, Yavuz Emre ŞÜKÜR, Bülent BERKER

Laparoscopic myomectomy is safe in patients with previous abdominal surgery

Aims: The excision of myomas is commonly carried out in symptomatic women who choose to preserve their uterus, either using an open or minimally invasive (hysteroscopy, laparoscopy, robotic) approach. Patient selection is a critical factor in achieving a successful laparoscopic myomectomy. Prior abdominal surgery was not defined as a risk factor, however, the safest approach in these cases is still the subject of intense debate The aim of this study was to evaluate the safety of laparoscopic myomectomy in patients with previous abdominal surgery. Methods: A retrospective cohort study was conducted on the files and operative notes of the patients who underwent laparoscopic myomectomy operation in a university-hospital based gynaecology department between January 2012 and March 2017. The patients were classified into two groups; Group 1 consisted of 34 patients who had previously undergone abdominal surgery, whereas the Group 2 comprised 118 patients who had not undergone any abdominal surgery. Results: There were no significant difference between patients with and without a history of abdominal surgery in terms of operation time, postoperative hospital stays, blood loss, rate of operative complications, or conversion rate to open surgery. Conclusion: A history of abdominal surgery seems to have no negative impact on the safety of a subsequent laparoscopic myomectomy.

Keywords:

laparoscopy, myomectomy, minimal invasive surgery, surgical outcome,

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Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107.
Stewart EA. Uterine fibroids. Lancet. 2001;357(9252):293-298.
Saridogan E, Cutner A. Endoscopic management of uterine fibroids. Hum Fertil (Camb). 2006;9(4):201-208.
Saridogan E. Surgical treatment of fibroids in heavy menstrual bleeding. Womens Health (Lond). 2016;12(1):53-62.
Bhave Chittawar P, Franik S, Pouwer AW, Farquhar C. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2014(10):CD004638.
Tulandi T, Youseff H. Laparoscopy-assisted myomectomy of large uterine myomas. Gynaecological Endoscopy. 1997;6(2):105-108.
Sizzi O, Rossetti A, Malzoni M, et al. Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol. 2007;14(4):453-462.
Chi I, Feldblum PJ, Balogh SA. Previous abdominal surgery as a risk factor in interval laparoscopic sterilization. Am J Obstet Gynecol. 1983;145(7):841-846.
Rosen DM, Lam AM, Chapman M, Carlton M, Cario GM. Methods of creating pneumoperitoneum: a review of techniques and complications. Obstet Gynecol Surv. 1998;53(3):167-174.
Bhoyrul S, Vierra MA, Nezhat CR, Krummel TM, Way LW. Trocar injuries in laparoscopic surgery. J Am Coll Surg. 2001;192(6):677-683.
Postoperative adhesion development after operative laparoscopy: evaluation at early second-look procedures. Operative Laparoscopy Study Group. Fertil Steril. 1991;55(4):700-704.
Champault G, Cazacu F, Taffinder N. Serious trocar accidents in laparoscopic surgery: a French survey of 103,852 operations. Surg Laparosc Endosc. 1996;6(5):367-370.
Heinberg EM, Crawford BL, 3rd, Weitzen SH, Bonilla DJ. Total laparoscopic hysterectomy in obese versus nonobese patients. Obstet Gynecol. 2004;103(4):674-680.
Granata M, Tsimpanakos I, Moeity F, Magos A. Are we underutilizing Palmer's point entry in gynecologic laparoscopy? Fertil Steril. 2010;94(7):2716-2719.
Dessolle L, Soriano D, Poncelet C, Benifla JL, Madelenat P, Darai E. Determinants of pregnancy rate and obstetric outcome after laparoscopic myomectomy for infertility. Fertil Steril. 2001;76(2):370-374.
Mallick R, Odejinmi F. Pushing the boundaries of laparoscopic myomectomy: a comparative analysis of peri-operative outcomes in 323 women undergoing laparoscopic myomectomy in a tertiary referral centre. Gynecol Surg. 2017;14(1):22.
Malzoni M, Rotond M, Perone C, et al. Fertility after laparoscopic myomectomy of large uterine myomas: operative technique and preliminary results. Eur J Gynaecol Oncol. 2003;24(1):79-82.
Malzoni M, Sizzi O, Rossetti A, Imperato F. Laparoscopic myomectomy: a report of 982 procedures. Surg Technol Int. 2006;15:123-129.
Tummers F, Peltenburg SI, Metzemaekers J, Jansen FW, Blikkendaal MD. Evaluation of the effect of previous endometriosis surgery on clinical and surgical outcomes of subsequent endometriosis surgery. Arch Gynecol Obstet. 2023.
Seo ES, Lee SH, Chon SJ, Jung SY, Cho YJ, Lim S. Influence of previous abdominal surgery on clinical outcomes of patients undergoing total laparoscopic hysterectomy. Obstet Gynecol Sci. 2018;61(3):379-385.