Laparoendoscopic single-site (LESS) myomectomy: characteristics of the appropriate myoma.

Yoon, Aera; Kim, Tae-Joong; Lee, Yoo-Young; Choi, Chel Hun; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

OBJECTIVE To describe the characteristics of 35 myomas in 28 patients who underwent laparoendoscopic single-site myomectomy (LESS-M). STUDY DESIGN Retrospective analysis of 28 patients who underwent LESS-M at Samsung Medical Center from January 2009 to January 2013. RESULTS The median age of 28 patients was 34 years (range: 27-61) and median body mass index was 21.9 (range: 17.3-28.5). The median number of extracted myomas was one (range: 1-4) and the largest myoma diameter was 6cm (range: 2-15). The total number of extracted myomas was 35 and the types of extracted myoma were subserosal (16 myomas, 45.7%), intramural (nine myomas, 25.7%) and intraligamentary (seven myomas, 20%). In subserosal and intramural myoma, 21 myomas were located at the anterior wall and four myomas were located at the posterior wall of the uterus. Median operation time was 131min (range: 35-232). Estimated intraoperative blood loss was 65mL (range: 20-300), hemoglobin change was 2g/dL (range: 0.5-2.9) and hospital stay was 3 days (range: 1-4). There was no conversion to laparotomy but in one patient (3.6%), LESS-M converted to two-port laparoscopic myomectomy. There was no blood transfusion during and after operation. Intraoperative and postoperative complications did not occur. CONCLUSION Careful selection of patients considering the type and location of myomas is important for successful LESS-M. Myomas located in the anterior wall, subserosal or intraligamentary myomas are appropriate for LESS-M.