Yonsei Med J.  2016 Nov;57(6):1531-1534. 10.3349/ymj.2016.57.6.1531.

Robot-Assisted Laparoscopic Adenomyomectomy for Patients Who Want to Preserve Fertility

• Chung YJ
• Kang SY
• Choi MR
• Cho HH
• Kim JH
• Kim MR

• KMID: 2427177
• DOI: http://doi.org/10.3349/ymj.2016.57.6.1531

Abstract

An adenomyomectomy is a conservative-surgical option for preserving fertility. Conventional laparoscopic adenomyomectomies present difficulties in adenomyoma removal and suturing of the remaining myometrium. Robot-assisted laparoscopic surgery could overcome the limitations of conventional laparoscopic surgery. Four patients with severe secondary dysmenorrhea and pelvic pain visited Seoul St. Mary's Hospital and were diagnosed with adenomyosis by pelvic ultrasonography and pelvic magnetic resonance imaging (MRI). The four patients were unmarried, nulliparous women, who desired a fertility-preserving treatment. We performed robot-assisted laparoscopic adenomyomectomies. The dysmenorrhea and pelvic pain of the patients nearly disappeared after surgery. No residual adenomyosis was observed on the follow-up pelvic MRI. A robot-assisted laparoscopic adenomyomectomy was feasible, and could be a minimally invasive surgical option for fertility-sparing treatment in patients with adenomyosis.

Keyword

Robotic surgical procedure; adenomyosis; surgery; fertility preservation; minimally invasive surgery

MeSH Terms

Adenomyoma
Adenomyosis/diagnosis/diagnostic imaging/*surgery
Dysmenorrhea
Female
Fertility
*Fertility Preservation
Gynecologic Surgical Procedures/adverse effects/*methods
Humans
Laparoscopy/*methods
Magnetic Resonance Imaging
Myometrium
Pelvic Pain/*diagnostic imaging/surgery
*Robotics
Treatment Outcome

Figure

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  Fig. 1 Operative procedures. (A and B) Injection of diluted vasopressin into an adenomyoma. (C and D) Removal of an adenomyoma from the uterus with minimal thermal damage. (E) Bleeding control. (F) Repair of the remaining myometrium and serosa.

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  Fig. 2 Preoperative and postoperative MRI findings. (A) Preoperative image. (B) Postoperative image. MRI, magnetic resonance imaging.

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