Name
09625 - Laparoscopic Retrograde Hysterectomy for a Large Broad Ligament Fibroid
Presenting Author
Shintaro Sakate
Affiliation
Kurashiki Medical Center
Abstract
- Study Objective: To demonstrate a retrograde approach of laparoscopic hysterectomy for a patient with a large broad ligament fibroid.
- Design: N/A
- Setting: Gynecology and Obstetrics department of a general hospital.
- Patients or Participants: 56-years-old G1P0 female with chronic inflammatory demyelinating polyneuropathy presented with stomach bloating of one year’s duration. A thoracoabdominal computed tomography scan was performed to rule out malignancy. A large uterine tumor was detected and MRI showed a 14-centimeter uterine tumor and cellular leiomyoma was suspected.
- Interventions: A total laparoscopic hysterectomy and bilateral salpingo-oophorectomy was performed and the 14cm fibroid was found to be in the right retroperitoneal space. Uterine manipulation and devascularization around the fibroid were extremely difficult, therefore the right parametrium was dissected in a retrograde fashion after the left parametrium dissection and colpotomy. The patient had an uncomplicated postoperative course and leiomyoma of uterus was diagnosed.
- Measurements and Main Results: N/A
- Conclusion: In cases of a large broad ligament or cervical fibroid, factors impacting the ease of surgery include limited access to vascular pedicles and decreased uterine maneuverability. These issues can lead to increased risks of hemorrhage and injury to bowel or urinary tract. The retrograde approach, in which the parametrium and ureter of the affected side are dissected after improvement of uterine maneuverability, is a safe and feasible procedure for laparoscopic hysterectomy in patients with a large broad ligament fibroid.
Authors
Sakate, S*, Ochi, Y, Andou, M. Kurashiki Medical Center, Kurashiki, Japan
Primary Category
Fibroids
Secondary Category
Laparoscopy