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Bhawna Bansal 10.5005/jp-journals-10033-1289
REVIEW ARTICLE

Minimally Invasive Surgical Techniques vs Open

Myomectomy for Treatment of Uterine Fibroids

Bhawna Bansal

ABSTRACT only when symptomatic. Symptoms associated with
Introduction: Myomectomy is the surgical remedy of prefer- fibroids include abnormal uterine bleeding, infertility,
ence for women with symptomatic fibroids, who prefer or want severe pain, and complications in pregnancy.
uterine conservation. Myomectomy can be finished by using Traditionally, the treatment of fibroids is surgical,
conventional laparotomy, by means of minilaparotomy, or by but various medical treatments including progesterones
means of minimal access techniques, such as hysteroscopy and
laparoscopy. Since the advent of minimal access surgery, there and gonadotropin-releasing hormone (GnRH) analogues
has been interest in the relative advantages and disadvantages have been tried. The surgical treatment of choice in women
of both surgical modalities. who prefer to conserve their uterus is myomectomy. The
Objectives: To determine the benefits and harms of laparo- routes to perform myomectomy are conventional lapa-
scopic myomectomy compared with open myomectomy. rotomy, minilaparotomy, and minimal access techniques,
Materials and methods: We used various search engines – such as laparoscopy and hysteroscopy.
PubMed, HighWire Press, Google, and Yahoo – to search for Laparoscopic myomectomy is suggested to be asso-
all trials and articles comparing myomectomy via laparotomy, ciated with reduced morbidity compared with open
minilaparotomy, or laparoscopically assisted minilaparotomy
vs laparoscopy. We found several articles of which 10 were myomectomy. Evidence suggests that laparoscopic
used in this review article based on the outcomes studied, myomectomy is associated with reduced morbidity
date of publication (after 2005), methodology of study, level of compared with open myomectomy, including reduced
evidence, and the journal in which they were published. The blood loss, postoperative pain, and shorter hospital
results of these trials were then compared.
stay. Comparable rates of pregnancy, fibroid recurrence,
Conclusion: Laparoscopic myomectomy is a process associ- and operative complications have also been reported.
ated with less subjectively reported postoperative pain, lower However, due to small sample size in most clinical trials
postoperative fever, and shorter hospital stay as opposed to
all kinds of open myomectomy. No data suggested a dif- conclusive evidence regarding the preferred surgical
ference in recurrence risk between laparoscopic and open approach is still not available.
myomectomy. Even more studies are needed to determine It is important to know the best surgical approach
fertility outcomes, rates of uterine rupture, occurrence of
thromboembolism, and need for repeat myomectomy and so as to help surgeons and patients make an informed
hysterectomy at a later stage. choice.
Keywords: Blood loss, Laparoscopic, Laparotomy, Myomec-
tomy, Pain, Postoperative. OBJECTIVES

How to cite this article: Bansal B. Minimally Invasive Surgical The objective behind undertaking this review is to
Techniques vs Open Myomectomy for Treatment of Uterine analyze the different studies available and the quality
Fibroids. World J Lap Surg 2016;9(3):126-129.
of evidence and study the advantages and disadvantages
Source of support: Nil of different surgical approaches.
Conflict of interest: None
MATERIAlS AND METhODS
INTRODUCTION
We used various search engines, such as PubMed, High-

Fibroids are common benign tumors of the uterus. They Wire Press, Google, and Yahoo to search for all trials and
are asymptomatic in most women and warrant treatment articles comparing myomectomy via laparotomy, mini-
laparotomy, or laparoscopically assisted minilaparotomy
vs laparoscopy. Among the trials found, we chose 10
Consultant
that had studied similar outcomes. Date of publication,
Vihaan Healthcare, Rohini, Delhi, India methodology of trial, level of evidence, and the journal
Corresponding Author: Bhawna Bansal, Consultant, Vihaan in which they were published. The results of these trials
Healthcare, Rohini, Delhi, India, e-mail: mail2bhawna@gmail. were then compared and tried to reach a definitive
com
conclusion regarding the best surgical approach.

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