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