The role of laparoscopic myomectomy in women of reproductive age.

Laparoscopic surgery has gained wide popularity for the treatment of uterine fibroids in women of reproductive age. The aim of this study is to evaluate the safety of the present surgical technique in order to preserve fertility and to achieve a satisfactory uterine repair so as to obtain an uncomplicated, full-term pregnancy. Between March 1988 and April 2001, 1170 uterine myomata were laparoscopically removed in 635 patients. The number of myomata removed from each patient varied from one to nine. The main steps of the surgical technique are described. No serious complication occurred. All the myomata proved to be benign. A second look was performed in 121 patients, and in two cases adhesions were found. A total of 105 patients achieved pregnancy (one triplet and three twin) and 91 delivered. No uterine rupture or scar dehiscence was observed. Out of 148 patients who were infertile with one or more myomata larger than 30 mm, 74 achieved pregnancy, 63 spontaneously and 11 after IVF.