Opportunities for change and levelling up: a trust wide retrospective analysis of 8 years of laparoscopic and abdominal myomectomy.

Background: Laparoscopic myomectomy is increasingly considered the gold standard uterine preserving procedure and has well documented benefits over the open approach. Barriers that women have in accessing the most appropriate treatment need to be addressed to ensure optimal patient care and outcomes.

Objectives: To analyse rates of open and laparoscopic myomectomy at a large NHS trust and identify how many cases could potentially have been performed laparoscopically, and any variation between sites.

Women's experiences of birth and birth options counselling after laparoscopic or open myomectomy.

There is emerging evidence that vaginal birth after open and laparoscopic myomectomy may be safe in many pregnancies, however, there are no studies examining the perspectives of women who have given birth post myomectomy and their preferences regarding mode of birth. We performed a retrospective questionnaire survey of women who had an open or laparoscopic myomectomy followed by a pregnancy within 3 maternity units in a single NHS trust in the UK over a 5-year period. Our results revealed only 53% felt actively involved in the decision making for their birth plan and 90% had not been offered a specific birth options counselling clinic.

Laparoscopic myomectomy to facilitate laparoscopic resection of a bleeding interstitial ectopic pregnancy.

Interstitial pregnancies present a diagnostic and management challenge and are associated with significant bleeding risk. We present a case of an interstitial ectopic pregnancy where there was a diagnostic delay due to the presence of uterine fibroids and where a laparoscopic myomectomy was required in order to perform laparoscopic resection of the ruptured interstitial pregnancy.This case demonstrates the possibilities at laparoscopy for ectopic pregnancy, highlights the benefit of a structured 'buddy' system between gynaecology surgeons and brings attention to the paucity of literature on the unique management challenges of ectopic pregnancy in the presence of leiomyoma.

Surgical Intervention for Uterine Fibroids. Our 4-Year Experience and Literature Review: Is It Time to Centralise Care Provision Specialist Fibroid Centres?

Background: Leiomyomas are common in women of reproductive age, for whom treatment-stratification can be challenging. We assessed factors influencing pre-operative selection of surgical intervention and compare outcomes.

Patients And Methods: A literature review was performed and surgical interventions for fibroids at a London hospital (2015-2018) were retrospectively examined.

Returning to work after laparoscopic myomectomy: a prospective observational study.

Introduction: Laparoscopic myomectomy offers women many benefits over conventional open surgery, including an expedited recovery and return to employment. Our study evaluates the time taken for women to return to work after laparoscopic myomectomy and identifies factors prolonging recovery to > 8 weeks.

Material And Methods: We prospectively evaluated 94 women undergoing laparoscopic myomectomy by a single surgeon between January 2012 and March 2015.