Sano Rikiya, Suzuki Soichiro, Shiota Mitsuru
Department of Gynecologic Oncology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Surg J (N Y). 2019 Sep 11;6(Suppl 1):S44-S49. doi: 10.1055/s-0039-1694989. eCollection 2020 May.
Laparoscopic myomectomy (LM) is a minimally invasive surgery. However, several complications may occur in cases of extremely large myomas. For example, it can be difficult to acquire a full visual field, and the operation is limited by both technical and physiological restrictions. In addition, the volume of intraoperative bleeding is often increased in comparison to typically sized myomas; therefore, surgical indications are limited for technical reasons and for ensuring safety of the patient. Suturing and ligation techniques, which are indispensable in LM, are difficult procedures to perform. If clinicians are not confident in performing these procedures or experience difficulty in controlling bleeding, then they can alternatively choose to make a small incision in the abdominal wall and perform a procedure called laparoscopically assisted myomectomy. In this article, we describe the process of effectively using LM in cases with giant myomas.
腹腔镜子宫肌瘤切除术（LM）是一种微创手术。然而，在肌瘤极大的情况下可能会出现多种并发症。例如，可能难以获得完整的视野，并且手术受到技术和生理限制的双重制约。此外，与典型大小的肌瘤相比，术中出血量通常会增加；因此，出于技术原因和确保患者安全的考虑，手术适应症受到限制。缝合和结扎技术在LM中是必不可少的，但操作起来很困难。如果临床医生对执行这些操作没有信心或在控制出血方面遇到困难，那么他们可以选择在腹壁做一个小切口，进行一种称为腹腔镜辅助子宫肌瘤切除术的手术。在本文中，我们描述了在巨大肌瘤病例中有效使用LM的过程。
