Ingenuity of laparoscopic uterine myomectomy

Objective: Since laparoscopic surgery has more limitations than laparotomy; thus, it needs more ingenuity. Herein, we will examine and report the ideas we use for laparoscopic myomectomy at our hospital. Methods: First, set the abdominal wall lift, after which the first trocar will be inserted for the 5.5 mm camera, as the optical method. After inserting all the trocars, the pneumoperitoneum pressure should be 12 mmHg for observation of the abdominal cavity, and be kept at 5 mmHg during the surgical procedure. A 3-cm skin incision will be made on the pubis attached with a lap disc mini for inserting and removing needles, threads, and fibroids. Fibroids will be kept inside with a thread attached to it to prevent lost. Since the fibroids must be manually cut into small pieces by a scalpel, a tube, which is cut off from a syringe, will be used to prevent abdominal wall damage. Seprafilm will be used for the myomectomy wound with a special tube to be inserted for all cases. Discussion: It will be safe not to damage the gastrointestinal tract by using abdominal wall lift first. A tube cut off from a syringe made it easier to carry out the fibroid resection. The seprafilm was certainly placed by using a special tube. Conclusion: Laparoscopic myomectomy will be performed safely by using various ingenuities from the beginning to the end of the operation. Additionally, the time and cost of the operation will be reduced.