The surgical approach for myomectomy : Laparoscopy ?
Leiomyomas are a real worldwide public health problem. The symptomatic ones are treated by surgery in most of the cases. Leiomyomas are benign tumors. But among them the risk of sarcoma exists. Among women operated for myomas, sarcoma is noted on 0.23%… It means that a precise preoperative work-up is necessary, including ultrasonography and MRI. This evaluation will give also the operative access, mini-invasive as hysteroscopy, laparoscopy or laparotomy. Laparoscopy has precise indications. Unique leiomyoma of less than 12 cm is the best indication. Specially in patients desiring pregnancy. On the contrary multiple ones should be treated also by a conservative treatment, it means minilaparotomy. The complications of mini-invasive surgery are very rare. The risk of bleeding during surgery is low, depending of the expertise of the surgeon. In patients desiring pregnancy or with infertility, the myomectomy is done for improving the pregnancy rate.