Minimizing blood loss in laparoscopic myomectomy with temporary occlusion of the hypogastric artery

Introduction Uterine leiomyomas are common benign pelvic tumors. Currently, laparoscopic myomectomy (LM) is the preferred treatment option for women in fertile age group with symptomatic myomas. The authors hypothesize that combining LM a bilateral temporary occlusion of hypogastric artery (TOHA) using vascular clips minimizes uterine blood flow during surgery and can significantly reduce surgery-associated loss. Materials methods This single-center, prospective randomized study was conducted at Department Obstetrics Gynecology, Municipal Emergency Clinical Hospital Timisoara, Romania. Patients aged between 18 49 who wished to preserve fertility were included, provided they had intramural larger than 4 cm diameter deformed cavity. analyzed data from 60 myomectomies performed by single surgeon January 2018 December 2020. randomly assigned either: “LM + TOHA” (29 patients), “LM” (31 patients). study’s main objective evaluate impact TOHA on perioperative loss, expressed as mean differences Hb (delta Hb). Results Delta statistically lower compared group, ± standard (min–max): 1.68 0.67 (0.39–3.99) vs. 2.63 1.06 (0.83–4.92) g/dL, respectively ( p < 0.001). There significant higher need postoperative iron perfusion specifically 0 12 patients 0.001), anemia Necessary clipping time 10.62 2.47 (7–15) minutes, no overall operative time: 110.2 13.65 106.3 16.48 = 0.21). difference length hospitalization or 12-month post-intervention fertility. Discussion Performing prior has proven be valuable technique reducing while minimizing complications surgery, increase time. trial registration ISRCTN registry, www.isrctn.com ), identifier ISRCTN66897343.