Laparoscopic myomectomy using a modified type of reusable laparoscopic Roeder knot pusher to enhance positioning and tightening of the Roeder knot

Objective To describe the technique of laparoscopic: reconstruction of the uterine wall defect after laparoscopic enucleation of intramural fibroid, u sing a modified type of reusable laparoscopic knot pusher which enhances pr ecise positioning and adequate tightening of the Roeder knot. Setting A stand-alone one-day surgery unit. Subjects Six patients having laparoscopic enucleation of an intramural fibr oid. Interventions The defect in the uterine wall was reconstructed with open su rgery sutures tied extracorporeally using a Roeder knot which was slid and tightened with the knot pusher. Conclusions Since the Roeder knots were slid and tightened without blockage and the uterine wall was reconstructed without postoperative intramural ha ematoma in all patients, the impression is that the modified type of Roeder knot pusher used on standard sutures could be a low-price alternative to e ndoscopic sutures.