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Uterine artery occlusion at myomectomy.

Abstract：

OBJECTIVE:To demonstrate three approaches to uterine artery occlusion at time of myomectomy as a blood-sparing intraoperative technique. DESIGN:A step-by-step explanation of the procedure with surgical video footage. SETTING:Academic medical center. PATIENT(S):Patients undergoing laparoscopic myomectomy, for whom a uterine artery occlusion was performed before any uterine incision. INTERVENTION(S):A step-wise approach is applied before beginning the myomectomy portion of the procedure, which includes the following: [1] selecting the appropriate approach to uterine artery occlusion (lateral vs. posterior vs. anterior) on the basis of individual anatomy; [2] identification of relevant anatomy and important landmarks for the procedure; [3] isolating the uterine artery and identifying the ureter; [4] occluding the uterine artery. MAIN OUTCOME MEASURE(S):Successful identification of the ureter and uterine artery, and occlusion of the latter by surgical clipping. RESULT(S):In all cases, the uterine artery was clearly identified, as was the ureter, and surgical clips were placed, resulting in successful uterine artery occlusion. CONCLUSION(S):Uterine artery occlusion can be performed by three different approaches, as have been demonstrated in this video. A systematic review and meta-analysis of the literature supports the efficacy of this procedure in terms of limiting blood loss, blood transfusion, and fibroid recurrence, albeit at slightly longer operative times.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Zakhari A,Sanders AP,Murji A

doi

10.1016/j.fertnstert.2019.01.019

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

1030-1031

issue

5

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(19)30057-3

journal_volume

111

pub_type

杂志文章

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