Objective

To provide a video tutorial on myomectomy via mini-laparotomy in women with large uterine fibroids.

Design

Stepwise demonstration of the technique with narrated video footage.

Setting

Uterine fibroids represent the most common benign gynecologic disease, and myomectomy is a frequent reproductive surgery aiming to preserve or improve fertility. Abdominal and laparoscopic myomectomy are common treatments, but over the last decades, laparoscopy has become the preferred surgical approach because it provides significant advantages, such as shorter recovery time and a lower overall risk of complications. However, removal of large fibroids by laparoscopy is often technically challenging or even impossible.

Patient(s)

A 29-year-old woman presenting with urinary frequency and lower abdominal pressure due to a 14-cm diameter FIGO type 4 uterine fibroid in the anterior uterine wall.

Intervention(s)

Myomectomy via mini-laparotomy using a 4-cm transverse skin incision and morcellation with a scalpel using an atraumatic circular self-retaining wound retractor.

Main Outcome Measure(s)

Mini-laparotomy represents a safe and simple approach combining the benefits of laparoscopy, such as reduced postoperative pain, reduced morbidity, and shorter hospitalization time, and the benefits of laparotomy, such as shorter duration of surgery, cost-effectiveness, and no need for advanced laparoscopic skills.

Result(s)

Mini-laparotomy can provide preferable cosmesis compared with alternative approaches.

Conclusion(s)

Mini-laparotomy represents an alternative minimally-invasive approach for large uterine fibroids, resulting in good overall outcome and no need for special surgical skills or equipment including power-morcellators. With this video, we aim to expedite the clinical learning curve of this technique and believe that selected patients desiring fertility could benefit from its application on a broader scale in the future.

中文翻译：

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通过小型剖腹手术对大子宫肌瘤进行肌瘤切除术：分步视频教程

客观的

提供通过小型剖腹手术对患有大子宫肌瘤的女性进行子宫肌瘤切除术的视频教程。

设计

用叙述的视频片段逐步演示该技术。

环境

子宫肌瘤是最常见的良性妇科疾病，子宫肌瘤切除术是一种常见的生殖手术，旨在保持或提高生育能力。腹部和腹腔镜子宫肌瘤切除术是常见的治疗方法，但在过去的几十年中，腹腔镜已成为首选的手术方法，因为它具有显着的优势，例如恢复时间更短和并发症的总体风险更低。然而，通过腹腔镜切除大肌瘤通常在技术上具有挑战性，甚至是不可能的。

耐心）

一名 29 岁女性，因子宫前壁有一个直径 14 厘米的FIGO 4 型子宫肌瘤而出现尿频和下腹压。

干预措施

使用 4 厘米横向皮肤切口通过小型剖腹手术进行子宫肌瘤切除术，并使用无创伤圆形自保持伤口牵开器使用手术刀进行粉碎。

主要观察指标）

微型剖腹手术是一种安全、简单的方法，它结合了腹腔镜手术的好处，如减少术后疼痛、降低发病率和缩短住院时间，以及开腹手术的好处，如手术时间短、成本效益高、无需手术。先进的腹腔镜技术。

结果）

与其他方法相比，微型剖腹手术可以提供更好的美容效果。

结论

微型剖腹手术代表了治疗大子宫肌瘤的另一种微创方法，可带来良好的整体结果，并且不需要特殊的手术技能或设备，包括动力粉碎机。通过这段视频，我们旨在加快该技术的临床学习曲线，并相信选定的希望生育的患者可以在未来更广泛的应用中受益。