A modified suture technique for laparoscopic myomectomy

Study objective: The safety and efficacy of a modified laparoscopic suture performed by a surgeon assisted by an under-training assistant in the repair of uterine defect during laparoscopic myomectomy (LM) was evaluated. Design: Prospective clinical study (Canadian Task Force classification II-2). Setting: Tertiary care university hospital. Patients: Sixty-two women scheduled for myomectomy because of symptomatic uterine myomas. Intervention: Group A (n = 31): LM with a modified laparoscopic suture technique (the suture line was pulled out of the trocar, and tension of the suture was maintained by the surgeon's or assistant's hand). Group B (n = 31): LM with a traditional laparoscopic suture technique (intracorporeal continuous suturing with a string trimmed to 30 cm). Measurements and main results: The median operative time (100 minutes vs 90 minutes, p = .436) and blood loss (200 mL vs 150 mL, p = .771) were slightly greater in the LM with a modified laparoscopic suture technique group (group A), although these differences were not statistically significant. The total specimen weight, number of myomas removed, and length of hospital stay were similar in both groups. No patients in either group had serious complications. Conclusion: A modified laparoscopic suture by controlling the tail of the suture with the surgeon's hand while sewing laparoscopically can achieve a good approximation of uterine defect and is an acceptable alternative to help laparoscopic surgeons performing surgery assisted by an under-training assistant to complete the procedure.