Myomectomy | Suspicious Fibroid | Vaginal extraction | Safe Laparoscopy

Facebook: https://www.facebook.com/SafeLaparoscopy Subscribe to Our Channel https://bit.ly/2AwCggo Case: Suspicious myoma removed in a bag through a posterior colpotomy - Vaginal extraction A 49 year old patient with a vascularized posterior pedunculated fibroid. Gr2 P2 both by C/S After laparoscopic insertion, the fibroid looked degenerated Bipolar cautery was applied rather excessively on the base of the fibroid, whilst exerting traction on fibroid, thus, reducing bleeding. Attention! This woman had completed her family! This technique would NOT be advisable if the patient was requesting fertility, due to excessive myometrial burns In that case monopolar hook would have been used and the bleeding controlled with interrupted sutures. In this case, once the fibroid was removed, the uterine wound was closed with interrupted mattress sutures with inversion of the serosa A posterior colpotomy was performed whilst stretching the vagina on a synthetic bulbous colpotome, that allowed a laparoscopic bag to be directly inserted The fibroid was placed inside the bag and removed through the incision Betadine solution was used to wash the vaginal incision and pelvis after the extraction of the myoma. The solution was carefully washed away. The vagina was then closed with interrupted figure of eight monocril 0 size sutures. Complete hemostasis was achieved. The pelvis rinsed repeatedly and checked for hemostasis Surgical team - Safe Laparoscopy G. Pistofidis S. Kogeorgos P. Balinakos K. Dimiitropoulos #SafeLaparoscopy #Vagina #Fibroid