Laparoscopic myomectomy: A retrospective analysis of 432 cases.

International Journal of Research and Innovation in Social Science (IJRISS) | Volume V, Issue XI, November 2021 | ISSN 2454–6186

Laparoscopic myomectomy: A retrospective analysis of 432 cases.

Madhuka Rajakaruna*, Dhammike Silva, Supun Adeesha, Rukshani Edirisinghe
Department of Gynaecology and Obstetrics, Colombo South Teaching Hospital, Sri Lanka
*Corresponding Author

Abstract: Method: This is a retrospective study to analyzed data from 432 women who had undergone laparoscopic myomectomy at Colombo south teaching Hospital, Sri Lanka during the period of 10 years
Results: Mean age of the population was 35.5 years (SD 6.083) and majority were nulliparous (67%). Single fibroid found in 168 patients (38.9%) , fibroids 2-4 found in 199 patients (46.1%) and fibroids 5-10 found in 65 patients (15%). Mean blood loss was 159.4 +/- 68.03 ml while mean operative time was 124 +/- 49.6 minutes. Mean operative time is 92.23 minute for fibroid size less than 8cm vs 178.9 minute for fibroid more than 12cm. Mean blood is 115.25ml for fibroid less than 8cm vs 238.27ml for fibroid size more than 12cm. Mean operative time and blood loss are increased with posterior wall and broad ligament fibroids . However it is not statistically significant ( P Value 0.006 and 0.008 respectively) . Prolonged operative time did not impact on surgical out comes in terms of hospital stay and blood transfusion.
Conclusion : In experienced and expert hand, laparoscopic myomectomy is a safer procedure with good surgical out comes and low complication rate. Operative time and blood loss mainly associated with size of largest fibroid and number of fibroids. Open myomectomy may be benefit for number of fibroids > 10 when considering completeness of surgery. Hand morcellation through suprapubic port is a safe and effective method of specimen retrieval in laparoscopic myomectomy.

Key words: Laparoscopic myomectomy ,Surgical outcomes, Morcellation

I. INTRODUCTION

Laparoscopic Myomectomy is a challenging yet rewarding gynaecological surgery conducted worldwide by skilled laparoscopic surgeons. Colombo-South Teaching Hospital (CSTH) is the centre of excellence in Gynaecology Laparoscopic Surgeries in Sri Lanka and lead by an experienced surgeon who has got more than 15 years of hands-on advanced gynaecological laparoscopic surgeries in Sri Lanka. Fibroids are benign hormone sensitive monoclonal tumours that could grow into a range of a few millimetres to a massive mass in 20 to 30 % of women in reproductive age groupI,II. Uterine leiomyomas can be debilitating to women not only in fertile age group but also in peri and post-menopausal age groups in many aspects. Fibroids can significantly affect their quality of lives due to abnormal uterine bleeding, pelvic pain, pressure symptoms leading to bladder and bowel symptoms, and subfertility. The symptoms and effects of fibroids on a woman depends on the size or the volume, number, and the location of the of leiomyomas. Paul et al in his case series of uterine myomectomy has illustrated, pressure symptoms that negatively affect patient’s quality of life, heavy uterine bleeding with failed medical therapy, infertility, rapid growth, and suspected sarcomas as

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