CanSAGE 2022 | 42 – Laparoscopic Myomectomy in the Retzius Space
The Retzius space is an extraperitoneal region between the pubic symphysis and bladder. Development of masses in this space is rare. Few cases of leiomyomas in the Retzius space have been previously reported, all of which have been excised through laparotomy. In this video, we review the case of a healthy 36-year-old G1P1 patient with asymptomatic abdominal enlargement. Ultrasound and MRI showed a normal-sized uterus with a large pedunculated fibroid displacing the bladder and uterus to the right. The patient completed a 3-month course of leuprolide acetate and underwent a laparoscopic myomectomy. Intraoperatively, the fibroid was in the left Retzius space with no connection to the uterus. We describe a laparoscopic approach based on an understanding of pelvic anatomy that enables the surgeon to work within the Retzius space and achieve a successful laparoscopic myomectomy.