The Role of Hysteroscopic and Robot-assisted Laparoscopic Myomectomy in the Setting of Infertility

Clin Obstet Gynecol. 2016 Mar;59(1):53-65. doi: 10.1097/GRF.0000000000000161.

Abstract

Fibroids, the most common gynecologic condition in women of reproductive age, have traditionally been treated with hysterectomy. As more women delay childbearing, myomectomy becomes an essential component of the gynecologist's armamentarium. Minimally invasive approaches to myomectomy have been shown to decrease morbidity and reduce care-related costs, while improving reproductive outcomes. Hysteroscopic myomectomy is a reproducible and easily learned technique for the treatment of submucosal fibroids. Robot-assisted laparoscopic myomectomy overcomes most of the technical challenges of laparoscopic myomectomy for intramural and subserosal fibroids. The combined adoption of these technologies will allow more patients with fibroids to benefit from a minimally invasive approach.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / therapeutic use
  • Female
  • Gonadotropin-Releasing Hormone / analogs & derivatives
  • Goserelin / therapeutic use
  • Humans
  • Hysteroscopy / methods*
  • Infertility, Female / etiology
  • Infertility, Female / surgery*
  • Laparoscopy / methods*
  • Leiomyoma / complications
  • Leiomyoma / surgery*
  • Neoadjuvant Therapy
  • Robotic Surgical Procedures / methods*
  • Uterine Myomectomy / methods*
  • Uterine Neoplasms / complications
  • Uterine Neoplasms / surgery*

Substances

  • Antineoplastic Agents, Hormonal
  • Goserelin
  • Gonadotropin-Releasing Hormone