Uterine Myomas Clinical Trial
Official title:
A Randomized Controlled Trial of Hand-assisted Laparoscopic Myomectomy Versus Abdominal Myomectomy: Surgical Outcomes and Patient Satisfactions
The aim of this study was to evaluate the feasibility and usefulness of Hand-assisted laparoscopic surgery (HALS) for myomectomy, and compare it with the open approach in myomectomy.
Uterine myomas are the most common benign tumor of the female genital tract and the leading
indication for hysterectomy. Despite the fact that laparoscopic myomectomy is becoming
increasingly popular, laparoscopic myomectomy remains underutilized because of inherit
limitations. The limitations include technical challenges such as dissection of the myoma
from its bed using the correct plane or multilayer closure of the myoma bed and the concern
about the strength of the suturing and the subsequent risk of uterine rupture. As a result,
laparoscopic myomectomy is currently performed only by expert surgeons.
Hand-assisted laparoscopic surgery (HALS) is a unique surgical approach that may overcome
the limitations of pure laparoscopic surgery. HALS is not only less invasive than open
surgery but also causes less technical challenges than laparoscopic surgery based on its
manual nature and ability to use retractors. In gynecologic field, HALS has also been
employed in ovarian cancers and large ovarian tumors.
In theory, HALS seems appropriate procedure, similar to the open approach, for patients with
multiple or huge myomas. To date, no report has evaluated the feasibility and usefulness of
HALS compared with open surgery (OS).
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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