Arnold Advincula's Surgical Techniques

Minilaparotomy: Minimally invasive approach to abdominal myomectomy

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Technique for removing symptomatic fibroids in a nulliparous 37-year-old patient seeking fertility



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


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

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