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The tip of the iceberg fibroid effect; when to avoid transcervical resection. The utilisation of 3D pelvic ultrasonography for fibroid mapping.
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  • Alexandros Lazaridis,
  • Stylianos Kogeorgos,
  • Nikolaos Al-Achmar ,
  • George Pistofidis
Alexandros Lazaridis
Levkos Stavros The Athens Hospital

Corresponding Author:[email protected]

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Stylianos Kogeorgos
Levkos Stavros The Athens Hospital
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Nikolaos Al-Achmar
Levkos Stavros The Athens Hospital
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George Pistofidis
Levkos Stavros The Athens Hospital
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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.