Explain: Myomectomy

Content:

Clinical Information:

_{The year-old female patient had a chief complaint of [[ menorrhagea, dysmenorrhea, anemia, lower abdomianl pain, compression syndrome, myoma in rapid progression, infertility, repeat abortion ]].} Abdominal myomectomy and {{no, right, left, bilateral}} salpingo-oophorectomy,{{no, right, left, bilateral}} Oophorectomy, {{no, right, left, bilateral}} Salpingectomy, {{no, right, left, bilateral}} Enucleation of ovarian cyst.was performed. In addition, [[Lysis of adhesion, Incidental appendectomy, chromotubation]] was/were also performed during this surgery.

Operative Procedures:

Under general anesthesia, IV drip with IC needle, on Foley, the patient was put in supine position. The abdominal wall was cleaned with soap and alcohol betadine. Prophylactic antibiotics [Cefamezine, Zinacef] was given immediately before the operation. The abdominal wall was opened with {{ subumbilical longitudinal, pfannestial }} incision. The operative field was exposed with self retaining retractor and large wet gauze packing. There are myomas over the fundal and corpus area of the uterus. Vertical incision was made on the anterior wall over the myoma. Using blunt and sharp dissection, the myoma was separate from its capsule at its base. After the removal, the remaining cavity is closed and hemostasis secured by multiple rows of 1-0.chromic. The serosa was closed with a continuos 'baseball'-type suture of chromic. The abdominal wall was closed layer by layer The peritoneum below the umbilicus was approximated by 1-0 chromic catgut, the abdominal fascia was closed by 1-0 Vicryl continuous suture, the sub-cutaneous fat was approximated by 1-0 vicryl, and the skin, by autosuture. Scrupulous normal saline irrigation before closure of abdominal wall and between layers of closure was done to wash out the possible floating tumor cells. The patient was sent to POR intensive care unit for recovery and respiratory support.