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The aim is to verify, whether intraoperative temporary clipping of the uterine vessels with vascular clips can reduce blood loss significantly.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Uterine artery clipped | Experimental | Both uterine arteries are temporarily clipped by Yasargil clips during laparoscopic myomectomy. |
|
| Control group | No Intervention | Conventional laparoscopic myomectomy is performed. (No intervention to temporarily occlude uterine arteries is made) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| clipping of uterine arteries during laparoscopic myomectomy | Procedure | For laparoscopy standard instruments were used.For vascular clamping we used titan made YASARGIL vessel clips. The patient is put in a 20° Trendelenburg. The surgeon coagulates a 3-4 cm long segment of peritoneum over the ileopsoas muscle. Along the coagulated segment the peritoneum is opened. The surgeon identifies the ureter at its crossing over the common iliac vessels. After medializing the ureter, the pararectal space is opened and the internal iliac artery is identified and dissected till the origin of the uterine artery. The uterine artery is isolated over a distance of about 2 cm. The vascular clip is placed over the uterine artery. Yasargil Clips are applied exclusively in patients of intervention group. Myomectomy is performed in identical fashion in both groups. At the end of myomectomy the vessel clips are removed. The metroplasty is controlled for hemostasis after reopening of the uterine vessels. |
| Measure | Description | Time Frame |
|---|---|---|
| Blood loss during laparoscopic myomectomy | hemoglobin drop transfusion rate | perioperative (preop and postoperative day3) |
| Measure | Description | Time Frame |
|---|---|---|
| Patency of uterine artery after laparoscopic clipping | Doppler results of the uterine arteries | perioperative |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Charite University Hospital | Berlin | 12200 | Germany | |||
| Bernd Holthaus |
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| ID | Term |
|---|---|
| D007889 | Leiomyoma |
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D009379 | Neoplasms, Muscle Tissue |
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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|
| Damme |
| Germany |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |