Are there any limits for laparoscopic myomectomy?-tips & tricks.

Uterine leiomyomas, also known as fibroids or myoma uteri, are the most common benign pelvic tumor in women. They are monoclonal tumors arising from the smooth muscle cells and fibroblasts of the myometrium. Uterine leiomyomas are usually diagnosed in reproductive-aged women. Determination of the actual prevalence is so difficult because of heterogenous presentation of the disease. Although women having uterine leiomyomas may suffer from abnormal uterine bleeding, pelvic pain, pelvic mass, infertility, and obstetric complications, others remain asymptomatic. Approximately one-third of women with uterine leiomyomas will demand treatment depending on the severity of their symptoms Another important issue during management of myomas is the patient's desire for immediate or future childbearing as the therapeutic approaches result in different impacts on fertility. According to localization of uterine leiomyomas, surgical routes may differ in terms of hysteroscopy, laparoscopy or laparotomy. With recent advances in technical developments and increased surgical experiences, laparoscopic myomectomy has started to be preferred for many reasons such as less blood loss and pain, lower complications and adhesion formation, faster post-operative recovery, and shorter duration of hospital stay. The number, size, and location of the fibroids are important factors during decision of laparoscopic or open technique. Despite limited data in literature, different routes have no impact on live birth rate.