Infraligamentous myoma is a myoma rising from the lateral aspect of the uterus and developing inside the peritoneum of the broad ligament.
Like all other myomas it can be intramural or, more often, subserous or peduncolated. In this video, we show the case of a peduncolated infraligamentous myoma.
The procedure starts with the opening of the anterior leaf of the broad ligament and the section of the round ligament that we performed with a reusable ultrasonic scalpel oOly (Sonosurg™, Olympus). Than we injected a vasoconstrictor solution (5 UI of Vasopressin in 100 ml of saline) just below the myometrial surface covering the myoma. A blunt dissection was then performed to isolate the myoma from the retroperitoneal connective tissue until the myoma pedicle was displayed. We cut the myoma pedicle with bipolar coagulation and ultrasonic energy.
When the myoma was removed there were two holes in the posterior leaf of the broad ligament that we closed with several 2-0 Vycril figure of eight stiches.