The Journal of Minimally Invasive Gynecology
Volume 17, Issue 5 , Pages 551-554, September 2010

Risk Factors for Uterine Rupture after Laparoscopic Myomectomy

  • William H. Parker, MD

      Affiliations

    • John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California
    • Corresponding Author InformationCorresponding author: William H. Parker, MD, John Wayne Cancer Institute at Saint John's Health Center, 1450 10th St, Ste 404, Santa Monica, CA 90401-2831.
    • ,
  • Jon Einarsson, MD, MPH

      Affiliations

    • Department of Obstetrics and Gynecology, Harvard Medical School, Boston, Massachusetts
    • ,
  • Olav Istre, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Harvard Medical School, Boston, Massachusetts
    • ,
  • Jean-Bernard Dubuisson, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Hôpitaux Universitaires de Genève, Geneva, Switzerland

Received 11 March 2010; accepted 30 April 2010. published online 30 June 2010.

Abstract 

Case reports for uterine rupture subsequent to laparoscopic myomectomy were reviewed to determine whether common causal factors could be identified. Published cases were identified via electronic searches of PubMed, Google Scholar, and hand searches of references, and unpublished cases were obtained via E-mail queries to the AAGL membership and AAGL Listserve participants. Nineteen cases of uterine rupture after laparoscopic myomectomy were identified. The removed myomas ranged in size from 1 through 11 cm (mean, 4.5 cm). Only 3 cases involved multilayered closure of uterine defects. Electrosurgery was used for hemostasis in all but 2 cases. No plausible contributing factor could be found in 1 case. It seems reasonable for surgeons to adhere to techniques developed for abdominal myomectomy including limited use of electrosurgery and multilayered closure of the myometrium. Nevertheless, individual wound healing characteristics may predispose to uterine rupture.

Keywords: Uterine rupture, Laparoscopic myomectomy

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 The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

PII: S1553-4650(10)00236-0

doi:10.1016/j.jmig.2010.04.015

Refers to erratum:

  • Erratum

    The Journal of Minimally Invasive Gynecology November 2010 (Vol. 17, Issue 6, Page 809)

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 5 , Pages 551-554, September 2010

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