Tips and tricks : how to control bleeding in mini invasive myomectomy?

Authors

Mathilde Castel, Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, BP 350, 97448, Saint-Pierre Cedex, La Réunion, France.
Gaby Moawad, The George Washington University School of Medicine and Health Sciences, Washington, DC20052, United States of America.
Malik Boukerrou, Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, BP 350, 97448, Saint-Pierre Cedex, La Réunion, France; Université de la Réunion, UFR santé, 40, avenue de Soweto, Terre Sainte, BP 373 97455 Saint-Pierre cedex, La Réunion, France; Centre d'Études Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint-Pierre, France.
Phuong Lien Tran, Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Sud-Réunion, BP 350, 97448, Saint-Pierre Cedex, La Réunion, France; Université de la Réunion, UFR santé, 40, avenue de Soweto, Terre Sainte, BP 373 97455 Saint-Pierre cedex, La Réunion, France; INSERM, CIC 1410, Reunion University Hospital, 97448 Saint-Pierre, France. Electronic address: phuong.tran@chu-reunion.fr.

Document Type

Journal Article

Publication Date

9-26-2025

Journal

Journal of gynecology obstetrics and human reproduction

DOI

10.1016/j.jogoh.2025.103042

Keywords

bleeding control; myomectomy

Abstract

Myomectomy using laparoscopic approach offers patients reduced abdominal scars, better post surgical rehabilitation. However, bleeding control may pose a challenge in spite of techniques already described [1,2]. Our objective is to show a reproducible technique of bleeding control during mini invasive myomectomy. We performed a mini-invasive myomectomy using with robotic surgery, with Da Vinci, X. We describe the case of a 35 year-old women, gesta 0 para 0, who presented with menorrhagia, avec pelvic pain, because of a fibroma FIGO 2-5 of 8cm. She had a desire of pregnancy. We show tips and tricks to control bleeding: (a) two ways of accessing to uterine artery for its occlusion, using either a vascular clamp or a metallic clip; (b) sub serous infiltration with 20mL of xylocaine with 1% adrenalin, diluated in 100mL of NaCl serum using a oocyte punction needle; (c) suture with barbed suture. Blood loss was <200mL.

APA Citation

Castel, Mathilde; Moawad, Gaby; Boukerrou, Malik; and Tran, Phuong Lien, "Tips and tricks : how to control bleeding in mini invasive myomectomy?" (2025). GW Authored Works. Paper 7894.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7894

Department

Obstetrics and Gynecology