October 17th, 2017

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Title:
Laparoscopic Myomectomy: A Comparison of Surgical Techniques
Authors:  Maria Antonietta Castaldi, M.D., Lavinia Mosca, M.D., Giulio Toro, M.D., Nicola Colacurci, M.D., Giuseppe Signoriello, M.D., Ph.D., and Luigi Cobellis, M.D., Ph.D.
  OBJECTIVE: To evaluate 2 different techniques of myomectomy by comparing laparoscopy with 3 or 2 suprapubic ports, with regard to operative parameters and outcomes.

STUDY DESIGN: This was a retrospective nonrandomized study (Canadian Task Force classification II-2) set at the Second University of Naples, involving 67 patients who underwent laparoscopic myomectomy between January 2010 and March 2014. Patients were divided into 2 groups: Group A (n=37) underwent laparoscopic myomectomy with 3 operative ports, and Group B (n=30) underwent laparoscopic myomectomy with 2 operative ports.

RESULTS: Significant differences were observed in operative times and intraoperative blood loss. No significant difference was observed in number of removed myomas, although a significantly greater number of isthmic and infraligamentary myomas and a greater diameter of removed myomas were observed in the patients of Group A as compared to those in Group B. The degree of surgical difficulty, evaluated by visual analog scale, was higher in Group A.

CONCLUSION: Laparoscopic myomectomy with 2 operative trocars is, in our opinion, an effective and safe surgical approach with lower or at least comparable intraoperative difficulties and similar outcome. However, the technique with 3 operative trocars remains the best choice for large and difficult myomas.
Keywords:  fibroid uterus, fibroids, fibromyoma, gynecologic surgical procedures, gynecologic surgery, laparoscopic surgery, laparoscopic surgical procedure, laparoscopy, leiomyoma, minimally invasive surgical procedures, myoma, uterine myomectomy, uterine neoplasms
   
   
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