Evaluation of loop ligation of larger myoma pseudocapsule combined with vasopressin on laparoscopic myomectomy

Objective To study the effects of reducing hemorrhage by loop ligation of larger myoma pseudocapsules combined with vasopressin on laparoscopic myomectomy (LM). Design Prospective controlled clinical trial. Setting Sheng Jing Hospital, China Medical University. Patient(s) A total of 105 women with symptomatic single or multiple larger myomas (diameter 6–18 cm) in need of surgical intervention, who wished to retain their uteri, were randomly divided into three groups in our hospital from January 2006 to January 2008: A) loop ligation combined with vasopressin; B) vasopressin alone; and C) neither loop ligation nor vasopressin. All patients were treated by LM. Each group included 35 cases. Intervention(s) Loop ligation of larger myoma (6–18 cm) pseudocapsule combined with vasopressin before thoroughly enucleating the myoma. Main Outcome Measure(s) Operating time, blood loss, blood transfusion, postoperative stay in hospital, symptom improvement. Result(s) Average blood loss, postoperative stay in hospital, number of conversions to laparotomy, and need for transfusion because of bleeding during operation in group A were significantly lower than in groups B and C. All patients in group A underwent technically successful laparoscopic operations. Conclusion(s) Loop ligation of larger myoma pseudocapsules combined with vasopressin is a safe, effective, and promising new method to reduce bleeding during laparoscopic myomectomy and makes the laparoscopic operations with larger myomas easier.