Laparoscopic myomectomy using a modified type of reusable laparoscopic Roeder knot pusher to enhance positioning and tightening of the Roeder knot

To describe the technique of laparoscopic reconstruction of the uterine wall defect after laparoscopic enucleation of intramural fibroid, using a modified type of reusable laparoscopic knot pusher which enhances precise positioning and adequate tightening of the Roeder knot.

A stand-alone one-day surgery unit.

Six patients having laparoscopic enucleation of an intramural fibroid.

The defect in the uterine wall was reconstructed with open surgery sutures tied extracorporeally using a Roeder knot which was slid and tightened with the knot pusher.

Since the Roeder knots were slid and tightened without blockage and the uterine wall was reconstructed without postoperative intramural haematoma in all patients, the impression is that the modified type of Roeder knot pusher used on standard sutures could be a low-price alternative to endoscopic sutures.