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PubMed1961

Myometrial reconstruction following myomectomy. An improved technique utilizing overlapping laminations of myometrium to reinforce the uterine closure.

A simple, but much improved technique of myometrial reconstruction following myomectomy makes the line of closure much stronger, lessening the risk of uterine rupture at subsequent pregnancy.Basically, three laminations of myometrium are utilized to cover the endometrial wound with three layers of intact uterine muscle. The first myometrial layer is brought from above downward and coapted to the inner third of myometrium of the anterior uterine wall. The second lamination of uterine muscle is developed from the middle and outer thirds of the anterior uterine wall, stretched over the endometrial wound, then securely anchored to the base of the salvaged hood of myometrium that covered the nest of fibromyomata. The third myometrial lamination consists of the aforementioned hood of uterine muscle, which is drawn forward to help form a new portion of the anterior uterine wall. Approximately three-fourths of patients who had full term pregnancy after this procedure were delivered vaginally.

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