A novel technique for myomectomy - Intranodal surgery with an electromechanical tissue borer

OBJECTIVE: To investigate the possibility of clinical application of a new technique for myomectomy that involves morcellating the myoma within the my ometrium with a new instrument that minimizes invasion of the myometrium an d abdominal wall. STUDY DESIGN: In a pilot clinical study, myomectomy was performed on five w omen with uterine myomas and a normal menstrual cycle using a microwave coa gulator and electromechanical tissue borer of our invention. The length of the surgical incisions in the abdominal wall and myometrium, operating time and blood loss were measured. RESULTS: The mean length of the surgical incisions was 6.3 cm in the abdomi nal wall and 3.5 cm ill the myometrium. The mean operating lime tons 167 mi nutes, and the mean blood loss was 312 nit. The length of the incisions in the abdominal wall and myometrium per centimeter of the maximal diameter of the myoma was 0.78 and 0.42 cm, respectively. The incision tended to becom e smaller in successive operations. CONCLUSION: This new technique of myomectomy significantly reduced invasion of the abdominal wall and uterus.