Rogachevsky O. Laparoscopic organ-preserving operations in leiomyoma

The dissertation deals with the research of differentiated using of laparo-scopic and laparotomic access of myomectomy for improving surgical results. The dissertation contains the analysis of 180 cases of myomectomy carried out by laparoscopic method, and 60 cases of myomectomy carried out by laparotomic method. The new method of LAVM allows qualitatively, comfortably and quickly to suture wound of uterus after removing intramuscular node in laparoscopic operation. It is worked out the algorithm of differentiated using of laparoscopic and laparotomic access of myomectomy in the treatment of patients with single and multiple leiomyoma. On the basis of research laparoscopic myomectomy can be considered as a method of choice. It may be performed with or without stitches on the uterus wound depending on a reproductive plan of the patient as well as quantity, size, localization of fibroids. Laparoscopic assistence of vagynal myomectomy (LAVM) is recommended for removing single intramuscular or subse-rousfibroid (in diameter from 40 to 70 mm) with localization in the posterior wall or the fundus uteri. Open myomectomy is recommended for removing intramuscular or sub-seros fibroid with diameter of more than 70 mm. Laparoscopic myomectomy allows to decrease bloodless twice, to decrease a necessity in analgetics after operation as compared with classical transabdominal surgery. Patients can walk in 6 hours after laparoscopic operation. It permits to reduce twice the post-operating stay in the hospita.