Laparoscopic myomectomy for large myomas.

Uterine fibroids occur in >40% of women today. This paper describes operative techniques for the removal of huge fibroids (4-20 cm) laparoscopically, as an alternative to laparotomy, while preserving fertility potential. The fibroids were removed through circular incisions into the serosa, the raw uterine defects are closed by purse-string sutures, and the fibroids are morcellated before removal. Blood loss was minimized with vasopressin, and adhesion prevention was obtained with dexamethasone and Interceed. All 300 patients in this study had their fibroids removed successfully laparoscopically, with minimal blood loss, excellent recovery, and without complications.