Intraoperative Strategies to Minimize Blood Loss During Myomectomy

79 Views | Sep 27, 2019

Authors: Alysha Nensi, Deborah Robertson

Affliations: University of Toronto

Myomectomy is a common procedure performed by gynecologists for the conservative management of leiomyomas (fibroids). The surgical removal of fibroids can be associated with significant intraoperative blood loss and subsequent blood transfusion, which is an important morbidity associated with this elective procedure in reproductive-aged women. This video demonstrates various evidence-based strategies aimed at minimizing surgical bleeding during myomectomy. Techniques covered in this presentation include: (1) Preoperative use of medications such as vaginal/rectal misoprostal and intravenous tranexamic acid, (2) Intramyometrial injection of dilute vasopressin and (3) Temporary uterine artery occlusion with pericervical tourniquet. We demonstrate how these techniques can be used to minimize blood loss during abdominal, laparoscopic and robotic myomectomy.