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At least 631 records · Page 35Linked to original sources
PubMed1997

A new laparoscopic myomectomy technique for intramural fibroids penetrating the uterine cavity.

OBJECTIVE: To evaluate laparoscopic removal of intramural leiomyomata uteri penetrating the uterine cavity, with compression of the uterine isthmic vessels, repair of the endometrial defect, and reconstruction of the myometrium in three layers. STUDY DESIGN: 32 selected patients with penetrating intramural leiomyomata uteri were subjected to a new laparoscopic myomectomy technique. Conversion from laparoscopy to laparotomy, feasibility and safety of surgical technique, length of operation, hemoglobin loss, intra- and postoperative complications, and length of stay in hospital were evaluated. RESULTS: All laparoscopic myomectomy attempts were completed laparoscopically without blood transfusion. The operative time ranged from 127 min to 246 min, (mean 163 min). The mean hemoglobin fall was 0.74 g/ml and no intraoperative nor postoperative complication was observed. The average postoperative hospital stay was 7.5 h. CONCLUSION: This operation is safe, shows good reconstructive outcome, and offers an alternative approach to laparotomy, with all advantages of major surgery being executed through minimal access.

Adult↗
PubMed1995

Treatment of dysfunctional bleeding and fibroids by advanced endoscopic techniques with the Nd:YAG laser: from the present to the future.

Both the electrical current of the resectoscope and the energy of the Nd:YAG laser have been effective tools in the destruction of endometrial tissue to a sufficient depth to avoid regeneration. GnRH-agonist therapy effects a decrease in the total uterine cavity area which facilitates surgical treatment and reduces the risk of fluid overload syndrome. The recurrence rate of meno/metrorrhagia is higher when the uterine cavity is more than 10 cm2. The use of GnRH-agonists represents an adjunct for preoperative reduction of submucosal myomas so that subsequent hysteroscopic myomectomy is possible. A two-step hysteroscopic therapy combined with GnRH-agonist therapy is performed when the largest portion of the submucosal myoma is located in the uterine wall. In cases of numerous submucosal and intramural myomas, a laparoscopic supracervical hysterectomy is performed because of the high risk of recurrence after the hysteroscopic procedure.

Adult↗
PubMed1998

Pathology of uterine fibroids.

The pathological appearances of uterine leiomyomas at macroscopic, histological and ultrastructural levels are described and illustrated. Features useful in the differential diagnosis from other uterine spindle cell lesions are included, and an outline is given of the variable features found in different studies of the effects of gonadotrophin hormone releasing hormone analogues on uterine leiomyomas.

Diagnosis, Differential↗
PubMed2001

A new twist on the Waltman loop for uterine fibroid embolization.

The usual ipsilateral approach for uterine artery embolization is to form a Waltman loop. Newer nonbraided 4-F catheters can be problematic because of their tendency to kink or unfold while the loop is being formed. Herein, a modification of the Cope suture technique is described by which a Waltman loop is formed with use of a 4-0 Tevdek suture that allows the catheter to be folded back on itself, drawing it into the ipsilateral iliac artery. If necessary, the catheter can be prevented from unlooping by twisting the catheter on itself to lock it in position. The technique allows for efficient catheterization of the ipsilateral uterine artery.

Catheterization↗