Myomectomy with a hemostatic method.

概要

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When myomectomy is indicated and blood loss is expected to be large because of enuclation of large and multiple intramural myomatas and repairing the enuclated muscular cavities, we have performed hemostasis by bilaterally clamping the uterine artery and the infundibulopelvic ligament with arterial or vascular clamps. As the hemostatic method, the broad ligament between the round ligament and the infundibulopelvic ligament was cut 3-4 cm in length and the retroperitoneal space was opened to visualize the uterine artery. The uterine artery was separated from the interstitial tissues at the proximal portion of branching part from the internal iliac artery and held with teflon tape. The same technique was carried out on the contralateral side. The uterine artery and the infundibulopelvic ligament were clamped with Diefenbach's arterial clamps and Satinskey's vascular clamps, respectively.<BR>Five patients with primary and secondary sterility underwent myomectomy with the hemostaic method. The weight of the enuclated myomatas ranged from 200 g to 655 g (mean, 364 g). The mean blood loss was 216 ml. The mean duration of operation was 1hr and 56 min with the mean period of 28.8 min for hemostasis.<BR>This hemostatic method is safe and may be useful for extensive myomectomy as well as uteroplastic surgery for congenital anomalies of the uterus.
近畿産科婦人科学会の論文