Fertility Sparing Management of a Large Broad Ligament Fibroid

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY Journal of minimally invasive gynecology Pub Date : 2024-11-01 DOI:10.1016/j.jmig.2024.09.062

KM Sankey-Thomas , J Travieso , CA Salazar , M Williams-Brown , MT Breen

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Abstract

Study Objective

Demonstrate the safety and feasibility of a robotic approach to fertility sparing management of large broad ligament fibroid.

Design

Case presentation.

Setting

Academic tertiary care center.

Patients or Participants

37 year-old G1P0 with a large uterine mass, suspected to be a fibroid, presented desiring fertility sparing surgical management after a failed exploratory laparotomy myomectomy. MRI showed a large 15 cm mass in the right broad ligament.

Interventions

Preoperative management with uterine artery embolization. Robotic assisted laparoscopic myomectomy.

Measurements and Main Results

The fibroid was removed robotically with EBL of <50cc. A postoperative hysterosalpingogram showing intact uterine cavity and patent fallopian tubes.

Conclusion

Minimally invasive surgery is feasible for large broad ligament fibroids. Consideration of preoperative interventions with a multidisciplinary team, like UAE with interventional radiology, may optimize surgical outcomes. A second opinion by minimally invasive gynecologic surgeons can provide the option for fertility sparing surgery when it is not initially offered.

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大型阔韧带肌瘤的生育保护疗法

患者或参与者37岁，G1P0，有一个巨大的子宫肿块，怀疑是子宫肌瘤，在探查性开腹子宫肌瘤切除术失败后，希望进行保留生育功能的手术治疗。核磁共振成像显示右侧阔韧带有一个15厘米大的肿块。机器人辅助腹腔镜子宫肌瘤剔除术。术后子宫输卵管造影显示子宫腔完整，输卵管通畅。考虑与多学科团队进行术前干预，如与介入放射科合作进行超短波手术，可优化手术效果。微创妇科外科医生的第二意见可为最初未提供的保留生育功能手术提供选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.