Laparoscopic myomectomy: A retrospective analysis of 432 cases

Method: This is a retrospective study to analyzed data from 432 women who had undergone laparoscopic myomectomy at Colombo south teaching Hospital, Sri Lanka during the period of 10 years Results: Mean age of the population was 35.5 years (SD 6.083) and majority were nulliparous (67%). Single fibroid found in 168 patients (38.9%) , fibroids 2-4 found in 199 patients (46.1%) and fibroids 5-10 found in 65 patients (15%). Mean blood loss was 159.4 +/- 68.03 ml while mean operative time was 124 +/- 49.6 minutes. Mean operative time is 92.23 minute for fibroid size less than 8cm vs 178.9 minute for fibroid more than 12cm. Mean blood is 115.25ml for fibroid less than 8cm vs 238.27ml for fibroid size more than 12cm. Mean operative time and blood loss are increased with posterior wall and broad ligament fibroids . However it is not statistically significant ( P Value 0.006 and 0.008 respectively) . Prolonged operative time did not impact on surgical out comes in terms of hospital stay and blood transfusion. Conclusion: In experienced and expert hand, laparoscopic myomectomy is a safer procedure with good surgical out comes and low complication rate. Operative time and blood loss mainly associated with size of largest fibroid and number of fibroids. Open myomectomy may be benefit for number of fibroids > 10 when considering completeness of surgery. Hand morcellation through suprapubic port is a safe and effective method of specimen retrieval in laparoscopic myomectomy.