Laparoscopic Myomectomy

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Conference Name: SELSICON 2023

Conducted by: SELSI, Galaxy Care Hospital and Symbiosis Medical College, Pune

Surgeon(s)/Speaker(s): Dr. Vivek Marwa

Surgical Procedure: Gynecology-Uterus - Myomectomy

Location: Symbiosis Medical College, Pune.

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Indexsteps

1. Verses needle Insertion : Verses needle -Pneumoperitoneum

2. 1st port insertion : 1st port insertion

3. Bowel adhesiolysis : Bowel adhesiolysis

4. Hysteroscopy & selective cannulation : Hysteroscopy & selective cannulation

5. Inject Vasopressin : Inject Vasopressin

6. Subserous myomectomy : Subserous myomectomy

7. Intramural myomectomy : Intramural myomectomy

8. Suturing wall : Suturing wall

9. Bag preparation : Bag preparation

10. Morsullation within bag : Morsullation within bag

11. Closure : Port fascial closure & skin wound close

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port positions

1. Myomectomy port position : * Standard 4 ports * 10-15mm Umbilicus * Two 5mm ports on either side of umbilicus at the same level in mid clavicular line/semilunar line * 5mm port on left side 2cm above and medial to anterior superior iliac spine

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precautionary_measures

1. Precuationary Measures-Myomectomy : Sharp dissection of bowel,ensure complete homeostasis

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pre_post_measures

1. Preoperative investigations : Tablet Dulcolax 2 previous nights:new: Liquid diet 2 days before:new:Explain patient that need to convert surgery to open may arise

2. Preoperative measures : Catheterize bladder

3. Postoperative measures : Good pain relief :new: Early mobilisation

4. Warning signs in the postoperative period : Increasing abdominal pain,Fever,Ileus

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Surgical Instruments

1. 30 degree 10mm telescope

2. Visual Vasopressor Injection Needle

3. 15 mm morcellator