Laparoscopic myomectomy: Where do we stand?

Only myomas which are complicated and/or resistant to properly conducted medical treatment require surgical treatment. Between October 1 1990 and April 30 1994 we carried out 74 laparoscopic myomectomies for intramural myomas measuring 5cm or more, in 73 patients. The operations lasted 138 ± 62 min (range 40-330). We converted two cases to laparotomy. We observed no serious peri or postoperative complications. No repeat operations were needed, whether by laparotomy or by laparoscopy. These results prove that laparoscopic myomectomy is a safe and reliable technique, even for intramural myomas measuring 5cm or more. Despite these encouraging results, it must be remembered that the operation is lengthy and difficult and should only be performed by laparoscopic surgeons completely familiar with endoscopic knot tying.