THE COMPARISON OF LAPAROSCOPIC MYOMECTOMY AND LAPAROSCOPIC ASSISTED MYOMECTOMY FOR THE SURGICAL APPROACH TO MYOMAS

Objective: to compare the intraoperative and postoperative short-term outcomes of laparoscopic and laparoscopically assisted myomectomy for the management of uterine myomas. Design: Data from the files of the patients operated for uterin myomata were obtained and assessed. The cases operated directly with abdominal hysterectomy were excluded. Setting: Abant Izzet Baysal University, Faculty of Medicine, Department of Obstetrics and Gynecology, Bolu Patients: A total of 44 patients who admitted outpatient clinic of gynecology with the diagnosis of uterine myomatas and elected for laparoscopic surgical procedure. Interventions: Laparoscopic and laparoscopically assisted myomectomy. Main Outcome Measures: The association of surgical technique with patients' age, body mass index, parity, the size and number of myomas, intraoperative time, aspirated blood volume, intraoperative and postoperative complications and time of hospital stay. Results: No significant difference were found between both groups in patient demographics, body mass index, intraoperative complications and hospitalization day. The size and number of myomas were significantly higher in laparoscopy assisted myomectomy group than the laparoscopic myomectomy group, respectively (58,0 +/- 9,6 vs 51,45 +/- 8,0, p<0.05; 1,79 +/- 0,76 vs 1,45 +/- 0,58 p<0.05). Operation time and aspirated blood volume were significantly higher in laparoscopic myomectomy group than the laparoscopy assisted myomectomy group. (105 +/- 15 vs 68, +/- 14 p<0.05; 372 +/- 65 vs 266 +/- 52 p<0.05). Conclusion: The collected data in our research did not show a superiority for laparoscopic myomectomy over laparoscopic assisted myomectomy. However, after obtaining the surgical instrumentation such as faster morcellators which decrease operation time and gaining surgical expertise, laparoscopic myomectomy will be a good surgical alternative to laparoscopically assisted myomectomy.