Endoskopie 2010; 19(2): 56-60

Post-myomectomy adhesions: prevention

MUDr.Kristýna Kubínová, doc.MUDr.Michal Mára, CSc., doc.MUDr.David Kužel, CSc.

Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha

Introduction: Myomectomy is the golden standard in uterine fibroid treatment. It is, however, associated with a high risk of de-novo adhesion

formation. The way to eliminate adhesion formation is to use minimally-invasive surgical approach and antiadhesive barriers.

Materials and methods: Analysis of literary resources and data from our department. In our department a total of 27 second-look

laparoscopies after myomectomy with application of auto-cross-linked hyaluronic acid gel was performed. 21 patients underwent

laparoscopic (LM) and 6 open myomectomy (OM) as the primary procedure. On the second-look intraperitoneal adhesions were evaluated

and graded using a modified American Fertility Society (mAFS) scoring method.

Results: The group of patients after LM presented with following findings: dense adhesions 5 % patients, 66 % filmy adhesions and 29 %

of patients had no adhesions. The average mAFS score was 0.86. 100 % of patients after OM presented with dense adhesions and the

average mAFS score was 4.33.

Conclusion: Auto-cross-linked Hyaluronic acid gel is effective in adhesion formation prevention in laparoscopic myomectomy.

Keywords: myomectomy, adhesions, antiadhesive barriers, auto-cross-linked hyaluronic acid gel

Published: June 1, 2010  Show citation