Laparoscopic Myomectomy in a Tertiary Care Centre in Douala, Cameroon
Thomas Obinchemti Egbe *
Department of Obstetrics and Gynecology, Douala General Hospital, Box 4856, Douala and Faculty of Health Sciences, University of Buea, Box 63 Buea, Cameroon.
George Enonchong Enow-Orock
Department of Pathology, Faculty of Health Sciences, University of Buea and Buea Regional Hospital, Cameroon.
Gregory Edie Halle Ekane
Department of Obstetrics and Gynecology, Douala General Hospital, Box 4856, Douala and Faculty of Health Sciences, University of Buea, Box 63 Buea, Cameroon.
Charlotte Nguefack Tchente
Department of Obstetrics and Gynecology, Douala General Hospital, Box 4856, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
Eugene Belley-Priso
Department of Obstetrics and Gynecology, Douala General Hospital and Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.
*Author to whom correspondence should be addressed.
Abstract
Objective: To assess the feasibility and outcome of laparoscopic myomectomy with single or double-layer closure of myoma bed for management of myomas at a tertiary care centre in Douala, Cameroon.
Materials and Methods: Thirty patients with large or moderate-size myomas were managed laparoscopically from September 1996 to September 2008. The indications for surgery included subfertility, heavy menstrual bleeding, abdominal mass and lower abdominal pain. Pre‑operative evaluation included history, clinical examination and sonographic mapping. Myomas were enucleated and retrieved laparoscopically by morcellation. Myoma beds were sutured in a single or double layer by endoscopic intra-corporeal suturing depending on the depth of the fibroids.
Results: Among our patients, 14 (46.7%) presented with subfertility, 8 (26.7%) with heavy menstrual flow and 6 (20%) with abdominal mass. Two (6.7%) presented with lower abdominal pain. The average maximum diameter of myoma was about 8.5 cm. The mean duration of surgery was 123.2±90 min and blood loss was minimal. The mean post-operative stay in hospital was averagely 3.03 days. There were no intra-operative complications recorded among our series and hospital stay was uneventful.
Conclusion: With proper single layer closure of the myoma bed, laparoscopic myomectomy is feasible for moderate and even large myomas not more than three fibroids, and has excellent outcomes.
Keywords: Laparoscopy, myomectomy, leiomyomas, single or double layer closure