Laparoscopic adenomyomectomy and hysteroplasty: a novel method.

STUDY

OBJECTIVE

To evaluate a novel method of laparoscopic adenomyomectomy.

DESIGN

Prospective study (Canadian Task Force classification II-3).

SETTING

University-affiliated hospital.

PATIENTS: Fourteen women with adenomyosis.

INTERVENTION: Laparoscopic adenomyomectomy and hysteroplasty. After local injection by diluted vasopressin solution, a transverse incision was made in the adenomyotic tissue down to the endometrium, and the adenomyotic tissue was surgically removed with a monopolar needle. The normal muscle layer on the serosal membrane side was left as an upper and lower serosal flap. The flaps were overlapped and sutured to counteract the lost muscle layer to reconstruct the uterus. MEASUREMENTS AND MAIN OUTCOME: The changes of symptoms were evaluated before and after the operation. The visual analog scale of dysmenorrhea was significantly decreased, and hypermenorrhea was improved after the surgery. Postoperative pregnancy was achieved in 2 patients, and vaginal delivery was performed in the first case.

CONCLUSION

For specific cases, laparoscopic adenomyomectomy may be a suitable method to relieve symptoms with minimally invasive surgery while conserving the uteri.