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BioMed Research International
Volume 2018, Article ID 8250952, 9 pages
Review Article

Prevention and Management of Complications in Laparoscopic Myomectomy

1University of Nicosia Medical School, Nicosia, Cyprus
2European Academy for Gynecological Surgery (Nicosia Branch), 55-57 Andrea Avraamidi St., Strovolos, 2024 Nicosia, Cyprus
3Aretaeio Hospital, Strovolos, Nicosia, Cyprus
4St George’s, University of London MBBS Programme at the University of Nicosia Medical School, Nicosia, Cyprus
5European Society Gynaecological Endoscopy, Leuven, Belgium
6The European Academy for Gynecological Surgery, Leuven, Belgium
7Life Expert Centre, Schipvaartstraat 4, 3000 Leuven, Belgium
8Cahir Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany

Correspondence should be addressed to V. Tanos; moc.oieatera@sonat.v

Received 22 March 2017; Accepted 4 February 2018; Published 5 March 2018

Academic Editor: Ivo Meinhold-Heerlein

Copyright © 2018 V. Tanos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Myomectomy aims to preserve fertility, treat abnormal uterine bleeding, and alleviate pain. It should cause minimal damage to the endometrium, while being tolerable and durable, and reduce the incidence of myoma recurrence and complications including bleeding, hematoma, adhesions, and gravid uterus perforation. Training and experience are crucial to reduce complications. The surgical strategy depends on imaging information on the myomas. The position of the optical and secondary ports will determine the degree of ergonomic surgery performance, time and difficulty of myoma enucleation, and the suturing quality. Appropriate hysterotomy length relative to myoma size can decrease bleeding, coagulation, and suturing times. Bipolar coagulation of large vessels, while avoiding carbonization and myometrium gaps after suturing, may decrease the risk of myometrial hematoma. Quality surgery and the use of antiadhesive barriers may reduce the risk of postoperative adhesions. Slow rotation of the beveled morcellator and good control of the bag could reduce de novo myoma and endometriosis. Low intra-abdominal CO2 pressure may reduce the risk of benign and malignant cell dissemination. The benefits a patient gains from laparoscopic myomectomy are greater than the complication risks of laparoscopic morcellation. Recent publications on laparoscopic myomectomies demonstrate reduced hospitalization stays, postoperative pain, blood loss, and recovery compared to open surgery.