Laparoendoscopic single-site (LESS) myomectomy: characteristics of the appropriate myoma

Objective: To describe the characteristics of 35 myomas in 28 patients who underwent laparoendoscopic single-site myomectomy (LESS-M). Study design: Retrospective analysis of 28 patients who underwent LESS-M at Samsung Medical Center from January 2009 to January 2013. Results: The median age of 28 patients was 34 years (range: 27-61) and median body mass index was 21.9 (range: 17.3-28.5). The median number of extracted myomas was one (range: 1-4) and the largest myoma diameter was 6 cm (range: 2-15). The total number of extracted myomas was 35 and the types of extracted myoma were subserosal (16 myomas, 45.7%), intramural (nine myomas, 25.7%) and intraligamentary (seven myomas, 20%). In subserosal and intramural myoma, 21 myomas were located at the anterior wall and four myomas were located at the posterior wall of the uterus. Median operation time was 131 min (range: 35-232). Estimated intraoperative blood loss was 65 mL (range: 20-300), hemoglobin change was 2 g/dL (range: 0.5-2.9) and hospital stay was 3 days (range: 1-4). There was no conversion to laparotorny but in one patient (3.6%), LESS-M converted to two-port laparoscopic myomectomy. There was no blood transfusion during and after operation. Intraoperative and postoperative complications did not occur. Conclusion: Careful selection of patients considering the type and location of myomas is important for successful LESS-M. Myomas located in the anterior wall, subserosal or intraligamentary rnyomas are appropriate for LESS-M. (C) 2014 Elsevier Ireland Ltd. All rights reserved.