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Minilaparotomy: Minimally invasive approach to abdominal myomectomy

A minilaparotomy is loosely defined as a laparotomy measuring between 4 cm and 6 cm. For the appropriate surgical candidate, a minilaparotomy is a useful alternative to laparotomy or laparoscopy, especially for large pathology.1 Benefits of minilaparotomy include improved pain management and postoperative recovery, as well as improved cosmetic outcome, with comparable blood loss and operative time.2,3

Vidyard Video

 In this video, we illustrate the key surgical steps of a minilaparotomy for the removal of large fibroids. These steps include:

  1. strategic vertical skin incision
  2. use of a self-retaining retractor
  3. infiltrate myometrium with dilute vasopressin
  4. strategic hysterotomy
  5. use of tenaculum for upward traction
  6. 10# blade scalpels for the “lemon wedge” coring technique
  7. layered closure.

Minilaparotomy myomectomy can be an excellent minimally invasive alternative to a traditional “full laparotomy” for women with large fibroids.

We hope that you find this video beneficial to your clinical practice.

>> Arnold P. Advincula, MD
 

WATCH FOR THIS VIDEO COMING SOON:

Laparoscopic bilateral salpingo-oophorectomy via minilaparotomy assistance for the massively enlarged adnexal mass

References
  1. Pelosi MA 2nd, Pelosi MA 3rd. Pelosi minilaparotomy hysterectomy: a non-endoscopic minimally invasive alternative to laparoscopy and laparotomy. Surg Technol Int. 2004;13:157-167.
  2. Fanafani F, Fagotti A, Longo R. Minilaparotomy in the management of benign gynecologic disease. Eur J Obstet Gynecol Reprod Biol. 2005;119:232-236.
  3. Glasser MH. Minilaparotomy: a minimally invasive alternative for major gynecologic abdominal surgery. Perm J. 2005;9:41-45.
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Author and Disclosure Information

Dr. Seaman is Resident, Department of Obstetrics & Gynecology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY.

Dr. Mattingly is Program Director, Minimally Invasive Gynecologic Surgery, Novant Health Pelvic Health & Surgery, Charlotte, North Carolina.

Dr. Advincula is Levine Family Professor of Women’s Health; Vice-Chair, Department of Obstetrics & Gynecology; Chief of Gynecology, Sloane Hospital for Women; and Medical Director, Mary & Michael Jaharis Simulation Center, Columbia University Medical Center, New York-Presbyterian Hospital. He serves on the OBG Management Board of Editors.

Dr. Advincula reports serving as a consultant to ConMed, CooperSurgical, Intuitive Surgical, and Titan Medical and receiving royalties from CooperSurgical. The other authors report no financial relationships relevant to this article.

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Author and Disclosure Information

Dr. Seaman is Resident, Department of Obstetrics & Gynecology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY.

Dr. Mattingly is Program Director, Minimally Invasive Gynecologic Surgery, Novant Health Pelvic Health & Surgery, Charlotte, North Carolina.

Dr. Advincula is Levine Family Professor of Women’s Health; Vice-Chair, Department of Obstetrics & Gynecology; Chief of Gynecology, Sloane Hospital for Women; and Medical Director, Mary & Michael Jaharis Simulation Center, Columbia University Medical Center, New York-Presbyterian Hospital. He serves on the OBG Management Board of Editors.

Dr. Advincula reports serving as a consultant to ConMed, CooperSurgical, Intuitive Surgical, and Titan Medical and receiving royalties from CooperSurgical. The other authors report no financial relationships relevant to this article.

Author and Disclosure Information

Dr. Seaman is Resident, Department of Obstetrics & Gynecology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY.

Dr. Mattingly is Program Director, Minimally Invasive Gynecologic Surgery, Novant Health Pelvic Health & Surgery, Charlotte, North Carolina.

Dr. Advincula is Levine Family Professor of Women’s Health; Vice-Chair, Department of Obstetrics & Gynecology; Chief of Gynecology, Sloane Hospital for Women; and Medical Director, Mary & Michael Jaharis Simulation Center, Columbia University Medical Center, New York-Presbyterian Hospital. He serves on the OBG Management Board of Editors.

Dr. Advincula reports serving as a consultant to ConMed, CooperSurgical, Intuitive Surgical, and Titan Medical and receiving royalties from CooperSurgical. The other authors report no financial relationships relevant to this article.

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A minilaparotomy is loosely defined as a laparotomy measuring between 4 cm and 6 cm. For the appropriate surgical candidate, a minilaparotomy is a useful alternative to laparotomy or laparoscopy, especially for large pathology.1 Benefits of minilaparotomy include improved pain management and postoperative recovery, as well as improved cosmetic outcome, with comparable blood loss and operative time.2,3

Vidyard Video

 In this video, we illustrate the key surgical steps of a minilaparotomy for the removal of large fibroids. These steps include:

  1. strategic vertical skin incision
  2. use of a self-retaining retractor
  3. infiltrate myometrium with dilute vasopressin
  4. strategic hysterotomy
  5. use of tenaculum for upward traction
  6. 10# blade scalpels for the “lemon wedge” coring technique
  7. layered closure.

Minilaparotomy myomectomy can be an excellent minimally invasive alternative to a traditional “full laparotomy” for women with large fibroids.

We hope that you find this video beneficial to your clinical practice.

>> Arnold P. Advincula, MD
 

WATCH FOR THIS VIDEO COMING SOON:

Laparoscopic bilateral salpingo-oophorectomy via minilaparotomy assistance for the massively enlarged adnexal mass

A minilaparotomy is loosely defined as a laparotomy measuring between 4 cm and 6 cm. For the appropriate surgical candidate, a minilaparotomy is a useful alternative to laparotomy or laparoscopy, especially for large pathology.1 Benefits of minilaparotomy include improved pain management and postoperative recovery, as well as improved cosmetic outcome, with comparable blood loss and operative time.2,3

Vidyard Video

 In this video, we illustrate the key surgical steps of a minilaparotomy for the removal of large fibroids. These steps include:

  1. strategic vertical skin incision
  2. use of a self-retaining retractor
  3. infiltrate myometrium with dilute vasopressin
  4. strategic hysterotomy
  5. use of tenaculum for upward traction
  6. 10# blade scalpels for the “lemon wedge” coring technique
  7. layered closure.

Minilaparotomy myomectomy can be an excellent minimally invasive alternative to a traditional “full laparotomy” for women with large fibroids.

We hope that you find this video beneficial to your clinical practice.

>> Arnold P. Advincula, MD
 

WATCH FOR THIS VIDEO COMING SOON:

Laparoscopic bilateral salpingo-oophorectomy via minilaparotomy assistance for the massively enlarged adnexal mass

References
  1. Pelosi MA 2nd, Pelosi MA 3rd. Pelosi minilaparotomy hysterectomy: a non-endoscopic minimally invasive alternative to laparoscopy and laparotomy. Surg Technol Int. 2004;13:157-167.
  2. Fanafani F, Fagotti A, Longo R. Minilaparotomy in the management of benign gynecologic disease. Eur J Obstet Gynecol Reprod Biol. 2005;119:232-236.
  3. Glasser MH. Minilaparotomy: a minimally invasive alternative for major gynecologic abdominal surgery. Perm J. 2005;9:41-45.
References
  1. Pelosi MA 2nd, Pelosi MA 3rd. Pelosi minilaparotomy hysterectomy: a non-endoscopic minimally invasive alternative to laparoscopy and laparotomy. Surg Technol Int. 2004;13:157-167.
  2. Fanafani F, Fagotti A, Longo R. Minilaparotomy in the management of benign gynecologic disease. Eur J Obstet Gynecol Reprod Biol. 2005;119:232-236.
  3. Glasser MH. Minilaparotomy: a minimally invasive alternative for major gynecologic abdominal surgery. Perm J. 2005;9:41-45.
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