A 16 weeks 1 para pregnant woman went to the emergency room and was hospitalized.
The sonographic examination showed a sub serous 15 cm myoma arising from the fundus. The patient was then operated, an open laparoscopy was performed and a Hasson trocar was inserted through the umbilicus. Then two 5 mm trocars were inserted:one at the level of the iliac spine and the other on the midline below the xiphoid. One 10 mm trocar was inserted on the left subcostal margin.
The pregnant uterus was irregular for the presence of two myomas: a 4 cm intramural myoma and a 15 cm subserous myoma with a large base. A thread was passed around the myoma base, a loop was performed with an extracorporeal (ROEDER) knot and the loop was progressively tied. The myoma base was then coagulated with the GIRUS bipolar generator and cutted with cold scissors. A second loop was applied.
Hemostasis was thoroughly checked and an adhesion barrier (INTERCEED) was applied. At the end of the procedure the fetal heart was checked. The myoma weight was 1.300 gr
Blood count of 05/07/2007: WBC 6.55, RBC 3.83, Hb 10.6, HCT 30.3, PLT 76.
Blood count of 06/07/2007: WBC 7.991, RBC 3.90, HB 10.7, HCT 30.8, PLT 78.
Postoperative period was uneventfull.