Temporary Simultaneous Two-arterial Occlusions During Laparoscopic Myomectomy

Temporary Simultaneous Two-arterial Occlusions to Reduce Operative Blood Loss During Laparoscopic Myomectomy: a Randomized Controlled Trial

The aim of this study was to evaluate the efficacy and safety of the temporary simultaneous two-arterial occlusions (TESTO) on operative blood loss during laparoscopic myomectomy.

Significant hemorrhage is major perioperative concern in myomectomy, and can result in need of blood transfusion, conversion to hysterectomy, development of hypovolemic shock and postoperative anemia, and delayed recovery. Therefore, methods to decrease operative blood loss during myomectomy in women wishing to preserve their uterus and fertility are important and must be developed.

Inclusion Criteria:

• women with symptomatic myomas such as menorrhagia, pelvic pressure/pain, or infertility
• women who were planning to undergo laparoscopic myomectomy
• women who had ≤ 10 myomas, with the largest myoma ≤ 10 cm
• women with regular menstrual bleeding
• women who were not pregnant at the surgery
• women between 19 and 48 years of age.

Exclusion Criteria:

• women who underwent concomitant complex surgical procedures at the time of laparoscopic myomectomy, such as severe adhesiolysis or resection for severe endometriosis
• women who were in postmenopausal or climacteric status
• women with a history of oophorectomy or salpingo-oophorectomy
• women with any suggestion of malignant uterine or adnexal diseases
• women with major medical comorbidities or psychiatric illnesses, which could affect follow-up and/or compliance
• women who refused to participate or give consent to the procedures