Laparoscopic versus ultraminilaparotomic myomectomy for the treatment of large uterine myomas

We compared short-term surgical outcomes of laparoscopic and ultraminilaparotomic procedures for the treatment of large uterine myomas in a retrospective matched-control study (Canadian Task Force classification II-2) of 32 women with large myomas who underwent laparoscopic myomectomy and 32 women who had ultraminilaparotomic myomectomy (< 4 cm incision). Myomectomies were successfully performed for all women in both groups, but time to discharge was significantly lower after laparoscopic than after ultraminilaparotomic myomectomy (p = 0.01). Laparoscopic myomectomy seems to be the preferable approach for the treatment of large myomas of >= 5 cm, providing a more rapid recovery compared to the ultraminilaparotomic approach. Ultraminilaparotomy may be a valid alternative in case of laparoconversion instead of the classic laparotomy approach.