Techniques of laparoscopic myomectomy

Myomectomy is one of the commonest gynaecological operations. Laparoscopic myomectomy has emerged over the last two decades as a possible alternative to the traditional laparotomy. Most studies have revealed that the laparoscopic procedure is at least as safe as the open procedure as to the rate of complications and may retain relevant advantages in terms of shorter admission and recovery times. Currently laparoscopic myomectomy is still a challenging operation that requires a well-trained surgical team, adequate instrumentation and accurate patient selection; the increasing slant of gynaecologists towards laparoscopic techniques, along with the advances in surgical instrumentation and suturing materials, will hopefully contribute to keep laparoscopic myomectomy no longer confined to tertiary care centres.Myomas or fibroids are common benign tumours of the uterus associated with infertility and other clinical manifestations such as abnormal bleeding. The surgical removal of myomas, also referred to as myomectomy, is a very common operation that can be carried out by laparotomy (traditional open operation), laparoscopy (key hole surgery) or hysteroscopy (accessing the uterine cavity via the cervix). Most studies have revealed that laparoscopic myomectomy is at least as safe as the open procedure as to the rate of complications and may retain relevant advantages in terms of shorter hospital stay and shorter time for recovery. On the other hand, laparoscopic myomectomy is currently a challenging operation that requires a very well-trained surgical team and adequate instrumentation and can only be offered to well-selected patients. The increasing slant of gynaecologists towards laparoscopic techniques, along with the advances in surgical instrumentation and suturing materials, will hopefully contribute to make laparoscopic myomectomy the standard procedure for myomectomy.