You are about to leave jnjmedtech.com. By clicking to continue, you will be taken to a web site governed by their own Legal and Privacy Policies.
Abdominal Myomectomy by Steven McCarus, MD
Authored by
Steven McCarus, MD
Authored by
Steven McCarus, MD
Abdominal Myomectomy by Steven McCarus, MD
Operative Steps
Operative Steps
- A Foley catheter is placed.
- Abdominal wall incision is made, layers of the abdomen are identified and opened, and after the incision is made self-retaining retractors are placed.
- The Uterus is injected with dilute vasopressin to minimize uterine bleeding.
- Using handheld cautery such as MEGADYNE Electrosurgical Pencils, an incision is made into the serosa of the uterus.
- The myometrium is coagulated and cut until the fibroid is reached.
- Progressing deeper into the myoma the surgeon identifies the plane between the fibroid and the myometrium by bluntly dissecting with the surgeon’s finger or knife.
- Applying traction with claps, the myoma can be extracted.
- Hemostasis is achieved with cautery, topical absorbable hemostats such as Surgicel SNoW, and sutures such as Vicryl Plus Synthetic Absorbable suture.
- After removing as many myomas as possible, Stratafix Symmetric PDS Plus suture will be used to approximate the myometrium.
- 3-0 Vicryl Plus Synthetic Absorbable suture is used to close the serosal layer.
- It is Important to control bleeding and obliterate dead space using topical absorbable hemostats such as Surgicel SNoW and sutures.
- Irrigating the uterus and pelvis in suctioning the fluid to check for bleeding prior to closing the abdominal wall.
- The peritoneum is closed with 3-0 Vicryl Plus Synthetic Absorbable suture in a continuous non locking manner.
- The fascia is approximated using 0- Stratafix Symmetric PDS Plus knotless tissue control device.
A subcuticular skin closure using 3-0 Stratafix Spiral Monocryl Plus knotless tissue control device.
Dermabond Prineo skin closure system can be used to close the skin