Tips and tricks: How to control bleeding in mini invasive myomectomy?

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction Pub Date : 2025-09-26 DOI:10.1016/j.jogoh.2025.103042

Mathilde Castel , Gaby Moawad , Malik Boukerrou , Phuong Lien Tran

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Abstract

Myomectomy using laparoscopic approach offers patients reduced abdominal scars, better post surgical rehabilitation. However, bleeding control may pose a challenge in spite of techniques already described [1,2]. Our objective is to show a reproducible technique of bleeding control during mini invasive myomectomy.

We performed a mini-invasive myomectomy using with robotic surgery, with Da Vinci, X. We describe the case of a 35 year-old women, gesta 0 para 0, who presented with menorrhagia, avec pelvic pain, because of a fibroma FIGO 2–5 of 8 cm. She had a desire of pregnancy. We show tips and tricks to control bleeding: (a) two ways of accessing to uterine artery for its occlusion, using either a vascular clamp or a metallic clip; (b) sub serous infiltration with 20 mL of xylocaine with 1% adrenalin, diluated in 100 mL of NaCl serum using a oocyte punction needle; (c) suture with barbed suture. Blood loss was <200 mL.

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小贴士：微创子宫肌瘤切除术中如何控制出血？

腹腔镜子宫肌瘤切除术使患者腹部疤痕减少，术后康复效果更好。然而，尽管已经描述了一些技术[1,2]，但出血控制可能会带来挑战。我们的目的是展示一种在微创子宫肌瘤切除术中可重复的出血控制技术。我们使用机器人手术进行了微创子宫肌瘤切除术，使用达芬奇，x。我们描述了一个35岁的女性，妊娠0 para 0，因FIGO 2-5的8cm纤维瘤而出现月经过多，骨盆疼痛。她渴望怀孕。我们展示了控制出血的技巧和技巧：(a)两种进入子宫动脉闭塞的方法，使用血管夹或金属夹；(b)浆膜下浸润20mL加1%肾上腺素的木卡因，用卵母细胞穿刺针稀释100mL NaCl血清；(c)用倒钩缝合。失血是

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来源期刊

Journal of gynecology obstetrics and human reproduction Medicine-Obstetrics and Gynecology

CiteScore

3.70

自引率

5.30%

发文量

210

审稿时长

31 days

期刊介绍： Formerly known as Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Journal of Gynecology Obstetrics and Human Reproduction is the official Academic publication of the French College of Obstetricians and Gynecologists (Collège National des Gynécologues et Obstétriciens Français / CNGOF). J Gynecol Obstet Hum Reprod publishes monthly, in English, research papers and techniques in the fields of Gynecology, Obstetrics, Neonatology and Human Reproduction: (guest) editorials, original articles, reviews, updates, technical notes, case reports, letters to the editor and guidelines. Original works include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses.