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Minimally Invasive Surgical Techniques vs Open Myomectomy for Treatment of Uterine Fibroids
laparoscopic uterine power morcellation in hysterec- of surgical approach on blood loss during intracapsular
tomy and myomectomy. Authors of this report suggest myomectomy. Minim Invasive Ther Allied Technol 2014
that occurrence of unsuspected uterine sarcoma among Mar;23(2):87-95.
patients undergoing hysterectomy or myomectomy for 3. Malzoni M, Tinelli R, Consentino F, Iuzzlino D, Surico D,
Reich H. Laparoscopy versus minilaparotomy in women
assumed benign leiomyoma is 1 in 352, and the preva- with symptomatic uterine myomas: short-term and fertility
lence of unsuspected uterine leiomyosarcoma is 1 in 498. results. Fertil Steril 2010 May;93(7):2368-2373.
Therefore, FDA concludes that when “using power mor- 4. Kalogiannidis I, Prapas N, Xiromeritis P, Prapas Y. Laparo-
cellation in women with unsuspected uterine sarcoma, scopically assisted myomectomy versus abdominal myo-
there would be a risk of spread of the cancerous tissue mectomy in short-term outcomes: A prospective study. Arch
Gynecol Obstet 2010 May;281(5):865-870.
within the abdomen and pelvis, significantly worsening 5. Cicinelli E,Tinelli R, Colaligilio G, Saliani N. Laparoscopy
the patient’s likelihood of survival. For this reason, and vs minilaparotomy in women with symptomatic uterine
because there is absolutely no reliable method for pre- myomas: A prospective randomized study. J Minim Invasive
dicting if the woman with fibroids may have an uterine Gynecol 2009 Jul-Aug;16(4):422-426.
sarcoma, the FDA attempts the use of laparoscopic power 6. Tan J, Sun Y, Dai H, Zhong B, Wang D. A randomized trial
morcellation during hysterectomy or myomectomy for of laparoscopic versus laparoscopic-assisted minilaparotomy
uterine fibroids.” 12-15 myomectomy for removal of large uterine myoma: Short-term
outcomes. J Minim Invasive Gynaecol 2008 Jul-Aug;15(4):
402-409.
CONClUSION 7. Sesti F, Copobiano F, Copozzolo T, Pielropolli A, Piccone E.
Isobaric gasless laparoscopy versus minilaparotomy in uterine
The popularity of minimal access surgery has been rising myomectomy: A randomized trial. Surg Endosc 2008 Apr;22(4):
over the past two decades. Some of it may be contributed 917-923.
to its increased accessibility to patients. Though there 8. Palomba S, Zupi E, Falbo A, Russo T, Marconi D, Tolino A,
do not appear to be considerable long-term benefits of Manguso F, Matte A, Zulio F. A multicenter randomized,
the laparoscopic approach, there seem to be little doubt controlled study comparing laparoscopic versus minilapa-
regarding immediate intra- and postoperative benefits rotomic myomectomy: Reproductive outcomes. Fertil Steril
2007 Oct;88(4):933-941.
of the same. 9. Holzer A, Jirececl S, Illievich UM, Huber J, Wenzl. Laparo-
More studies are needed to evaluate laparoscopically scopic versus open myomectomy: A double blind to evaluate
assisted minilaparotomy myomectomy compared with postoperative pain. Anesth Analg 2006 May;102(5):1480-1484.
open and laparoscopic myomectomy. This procedure 10. Alessandri F, Davide L, Emanuela M, Simone F, Nicole R.
is less challenging technically, and it avoids endosutur- Randomized study of laparoscopic versus minilaparotomic
ing and morcellation. Also more studies are needed to myomectomy for uterine myomas. J Minim Invasive Gynecol
2006 Mar-Apr;13(2):92-97.
evaluate whether surgical approach affects future fertility 11. Nieboer TE, Johnson N, Lethaby A, Tavendar E, Curr E, Gary
outcomes. R et al. Cochrane Database of systemic reviews. [Online]; 2009.
In conclusion, data suggests that when compared Available from http://www.ncbi.nlm.nih.gov.
with minilaparotomic myomectomy, laparoscopic 12. Food, Drug Administration. Quantitative assessment of
myomectomy may offer several benefits and faster the prevalence of unsuspected uterine sarcoma in women
postoperative recovery. Minimal access surgery is the undergoing treatment of uterine fibroids. Summary and key
findings. FDA Safety Communications; 2014.
way of future and, though more research is needed, it 13. Jin C, Hu Y,Chen X, Zheng F, Lin F, Zhou K, Chen FD, Gu HZ.
definitely scores a point over open approach in several Laparoscopic versus open myomectomy-a meta-analysis of
important aspects. randomized controlled trials. Eur J Obstet Gynecol Reprod
Biol 2009;145(1):14-21.
REFERENCES 14. Aziken ME. Laparoscopy hospital.com. [Online]. 2008. Avail-
able from: https://www.laparoscopyhospital.com/laparo-
1. Bhave Chittawar P, Frankin S, Pouwar AW, Farquhar C. scopic_myomectomy_versus_open_myomectomy.html
Cochane library. [Online]. 2014. Available from: http:// 15. Iavazzo C, Mamais I, Gkeqkes I. Robotic assisted vs laparo-
onlinelibrary.wiley.com. scopic and/or open myomectomy: Systematic review and
2. Tinelli A, Mettler L, Malvasi A, Hurst B, Catherino W, meta-analysis of the clinical evidence. Arch Gynecol Obstet
Mynbaev O, Guido M, Alkaout I, Schollmeyer T. Impact 2016 Jul;294(1):5-17.

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