Bleeding during laparoscopic myomectomy? It depends on the biology-based technique

Letter to the Editor

VOLUME 118, ISSUE 5, P995-996


Andrea Tinelli, M.D., Ph.D.


To the Editor:
I read with great interest the article entitled "Minimizing the complications of laparoscopic myomectomies: which technique should stay in the loop?” (1). The article discusses 2 methods used during the loop ligation of a myoma pseudocapsule: the intramyometrial vasopressin administration and myomectomies anticipated by preventive uterine artery occlusion. They have been shown to reduce intraoperative and postoperative blood loss and have contributed greatly toward successful laparoscopic myomectomies. The advantages and drawbacks of using both methods during laparoscopic myomectomy to reduce intraoperative and postoperative bleeding have been largely discussed. However, the article does not mention any biologic evidence that explains why myomectomy must be intracapsular and pseudocapsule sparing, above all without the use of either vasopressin or uterine artery occlusion.

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