Laparoscopic myomectomy for fibroids penetrating the uterine cavity: is it a safe procedure?

Abstract Objective The purpose of the study was to evaluate the post-operative course and follow up of women who had undergone laparoscopic removal of intramural fibroids penetrating the uterine cavity. Design Retrospective study. Setting Center for Reconstructive Pelvic Endosurgery, Italy. Population Thirty-four women with fibroids penetrating the uterine cavity. Methods Laparoscopic myomectomy. Main outcome measures Feasibility and safety of surgical technique, length of operation, blood loss, intra- or post-operative complications, length of hospital stay, resolution of symptoms and future obstetric outcome. Results The mean operative time was 79 (SD 30) minutes; the mean reduction in haemoglobin was 1.1 ± 0.9 g/dL. No intra- or post-operative complications were observed. The average post-operative stay in hospital was 54 (SD 22) hours. Nineteen (73%) out of 26 patients who had experienced symptoms prior to surgery reported resolution of these symptoms post-operatively. All patients resumed work within a mean time of 20 (SD 8) days. Among 23 of the 32 patients attempting pregnancy during the follow up period, nine (39%) conceived within one year. Seven pregnancies went to term without complications. Conclusion The clinical results of this study suggest that laparoscopic myomectomy for intramural fibroids penetrating the uterine cavity is a safe procedure, providing well known advantages of minimal access surgery.