Combined preoperative angiography with transient uterine artery embolization makes laparoscopic surgery for massive myomatous uteri a reasonable option: case reports.

Herein are reported perioperative outcomes in 2 women who underwent laparoscopic myomectomy and hysterectomy to treat massive leiomyomas. Although we counseled the patients about the high risk of conversion to laparotomy, we would not have attempted the laparoscopic approach without a preoperative angiogram and transient uterine artery embolization. Preoperative angiography and selective embolization enable identification of an aberrant parasitic blood supply and minimization of intraoperative bleeding. In the appropriate hands, these tools make a minimally invasive surgical approach possible even for the largest myomatous specimens.