Clinical assistant
Ann-Sophie Jensen
Department of Obstetrics and Gynecology, Odense University Hospital, OUH
| Project management | ||
| Project status | Open | |
| Data collection dates | ||
| Start | 01.09.2024 | |
| End | 30.09.2024 | |
Myomectomy - Impact of size and surgical procedure on postoperative pain perception and bleeding (The MISS study)
Short summary
The primary aim of the study is to identify women undergoing myomectomy (laparoscopic or robot-assisted) to investigate whether the size of the myomas influences the operation time, bleeding (ml) and the need for laparotomy (abdominal incision >5cm). Secondary, to investigate if the use of an intra-abdominal bag increases operation time and bleeding (ml).
Rationale
Myomectomy is one of the most frequent surgical procedures in gynecology. Myoma is a benign nodule in the uterus but in many cases, several myomas may be present. The incidence of benign myoma is high (found in approximately 30-50 % of all women). Laparoscopic surgery (laparoscopy or robot-assisted laparoscopy) for myomectomy is now recommended due to reduced postoperative pain, shorter hospital stay and less pain. Normally, the myoma is removed from abdominal cavity by a small incision either prepubic or by an abdominal incision, but in case of a large myoma it is necessary to make a large incision in the skin corresponding to a caesarean section to be able to pull it out. Therefore, electromechanical (power) or mechanic (knife) morcelation has been developed to make the hole in the stomach as small as possible, thereby avoiding making an opening in the stomach corresponding to a caesarean section. The two methods ensure that the myoma is cut into smaller fragments and that the fragments are collected continuously, although, it is rarely that all small fragments can be collected. In case of malignancy, which is a rare condition, the cancer may be spread all over the abdominal cavity. Therefore, in both cases a bag is introduced intra-abdominally where the myoma is placed before morcelation. It is obvious that the size of the myoma may have an impact of surgical time but currently only sparse information is available regarding whether the use of a bag intra-abdominal and either power or knife morcelation using a small abdominal incision may have an impact on pain perception, bleeding, and in hospital stay.
Description of the cohort
The study retrospectively identifies women with a laparoscopic or robot-assisted laparoscopic myomectomy at the Department of Obstetrics and Gynecology, Odense University Hospital, Denmark from September 2019 to September 2024. The study is a single-center study. The women are identified using ICD-10 codes. The ICD-10 codes used were KLCB10 and KLCB11. Women included were > 18 years with a laparoscopic or robot-assisted laparoscopic myomectomy.
Data and biological material
Data from medical records including demographic data, information regarding surgical procedure, and intraoperative and postoperative complications.