The tip of the iceberg fibroid effect; when to avoid transcervical
resection. The utilisation of 3D pelvic ultrasonography for fibroid
mapping.
- Alexandros Lazaridis
, - Stylianos Kogeorgos,
- Nikolaos Al-Achmar ,
- George Pistofidis
Abstract
ABSTRACT Our objective is to demonstrate that moderate size type 2-4
fibroids should be removed with laparoscopic myomectomy. The use of 3D
ultrasound imaging to accurately identify size and position of fibroid
is essential, since it guides operative strategy especially when
hysteroscopic evaluation of the submucosal fibroid component may give a
false impression of its size and transcervical resection feasibility. We
present a video demonstration of the diagnostic sequence and then
laparoscopic myomectomy in simple steps. In conclusion, robust
pre-operative assessment is necessary to avoid transcervical fibroid
resections requiring prolonged operative time or multiple sessions.