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Laparoscopic myomectomy with aquadissection and barbed sutures.

Modi R - J Gynecol Endosc Surg (2011)

Bottom Line: The whole of 400 ml of this saline is injected in the myometrium.Incision is made on the uterus with just simple scissors (no energy source is required).As the uterus is cut, instead of bleeding, saline leakage takes place.

View Article: PubMed Central - PubMed

Affiliation: Akola Endoscopy Centre, Akola, Maharashtra, India.

ABSTRACT
The objective of this study was to evaluate the efficacy of aquadissection technique to reduce the blood loss in myomectomy and to assess the benefits and feasibility of the use of barbed suture for myometrial defect closure. Vasopressin is diluted with saline as 10 units of vasopressin for every 100 ml of saline. For a fibroid of about 8 cm size, 40 units of vasopressin is diluted in 400 ml of normal saline. The whole of 400 ml of this saline is injected in the myometrium. Incision is made on the uterus with just simple scissors (no energy source is required). As the uterus is cut, instead of bleeding, saline leakage takes place. This helps to keep the field clear and it is easier to get the correct plane between the fibroid and the myometrium. The separation of the fibroid is helped due to the dissection of the correct plane by the saline injection.

No MeSH data available.


Related in: MedlinePlus

Before saline injection
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Figure 1: Before saline injection

Mentions: Vasopressin is diluted with saline as 10 units of vasopressin for every 100 ml of saline. For a fibroid of about 8 cm size, 40 units of vasopressin is diluted in 400 ml of normal saline. The whole of 400 ml of this saline is injected in the myometrium. Using a 10-ml syringe and a laparoscopic injection needle, from the 5 mm port, the injection needle is inserted between the uterus and the myoma. Needle is inserted to a depth of about 1 inch. Single insertion is sufficient in most cases. If needed, position of the needle may be changed once. Multiple sites will cause the injected saline to ooze out from the previous punctures. (Maintenance of cold chain of vasopressin inj. is essential.) As the effect of aquadissection with saline and vasopressin is achieved, the color of uterus changes from pink to white or marble like appearance [Figures 1 – 3]. Incision is made on the uterus with just simple scissors (no energy source is required).


Laparoscopic myomectomy with aquadissection and barbed sutures.

Modi R - J Gynecol Endosc Surg (2011)

Before saline injection
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3304286&req=5

Figure 1: Before saline injection
Mentions: Vasopressin is diluted with saline as 10 units of vasopressin for every 100 ml of saline. For a fibroid of about 8 cm size, 40 units of vasopressin is diluted in 400 ml of normal saline. The whole of 400 ml of this saline is injected in the myometrium. Using a 10-ml syringe and a laparoscopic injection needle, from the 5 mm port, the injection needle is inserted between the uterus and the myoma. Needle is inserted to a depth of about 1 inch. Single insertion is sufficient in most cases. If needed, position of the needle may be changed once. Multiple sites will cause the injected saline to ooze out from the previous punctures. (Maintenance of cold chain of vasopressin inj. is essential.) As the effect of aquadissection with saline and vasopressin is achieved, the color of uterus changes from pink to white or marble like appearance [Figures 1 – 3]. Incision is made on the uterus with just simple scissors (no energy source is required).

Bottom Line: The whole of 400 ml of this saline is injected in the myometrium.Incision is made on the uterus with just simple scissors (no energy source is required).As the uterus is cut, instead of bleeding, saline leakage takes place.

View Article: PubMed Central - PubMed

Affiliation: Akola Endoscopy Centre, Akola, Maharashtra, India.

ABSTRACT
The objective of this study was to evaluate the efficacy of aquadissection technique to reduce the blood loss in myomectomy and to assess the benefits and feasibility of the use of barbed suture for myometrial defect closure. Vasopressin is diluted with saline as 10 units of vasopressin for every 100 ml of saline. For a fibroid of about 8 cm size, 40 units of vasopressin is diluted in 400 ml of normal saline. The whole of 400 ml of this saline is injected in the myometrium. Incision is made on the uterus with just simple scissors (no energy source is required). As the uterus is cut, instead of bleeding, saline leakage takes place. This helps to keep the field clear and it is easier to get the correct plane between the fibroid and the myometrium. The separation of the fibroid is helped due to the dissection of the correct plane by the saline injection.

No MeSH data available.


Related in: MedlinePlus