Laparoscopic myomectomy: feasibility and safety—a retrospective study of 762 cases

The objective of this retrospective study of a case series was to evaluate patients with symptomatic uterine myomas managed by laparoscopic myomectomy--the clinical features, operative techniques, and intraoperative and postoperative morbidity. The subjects consisted of a total of 762 women who underwent endoscopic surgery for uterine leiomyomas at a private advanced endoscopy and assisted reproductive technology centre over a 13-year period. Data were collected on baseline clinical characteristics, details of surgery, intraoperative and postoperative complications, and hospital stay. A total of 1,375 myomas were removed; the most common indication was infertility (50.9%), and the majority of myomas (49.52%) were intramural. The mean duration of surgery was 95 min, and the average blood loss was 250.5 ml. The average hospital stay was 1.3 days. Major complications included an unexplained postoperative death and one laparotomy for postoperative bleeding. We conclude that laparoscopic myomectomy is a relatively safe procedure. Most cases can be completed by a laparoscopic approach, and the remaining may require a laparoscopic-assisted myomectomy. The risk of complications is comparable to that with the open procedure, whereas morbidity and length of hospital stay are much lower.[PUBLICATION ABSTRACT]