• The abdominal wall is elevated, an Ultra Veress Needle is placed through the umbilicus, CO2 gas is insufflated. 
  • A small skin incision is made at the umbilicus, then a non-bladed 5 mm trocar such as ENDOPATH XCEL™ Trocar is passed through the incision, confirmation that you are in the abdominal cavity is made with the laparoscope. 
  • Once the patient is in the Trendelenburg position, a 2nd and 3rd 11mm non-bladed trocars are passed through the abdominal wall.
     
  • Once the location of the fibroid is identified, Vasopressin is injected until blanching of the tissue is noticed. 
  • Securing the uterus with a grasper, HARMONIC™ 1100 is then used to cut the serosa covering the fibroid. This will expose the fibroid. Using traction and countertraction, the fibroid will be disengaged from the uterus. 
  • Myoma vessel control is accomplished by using an energy device such as HARMONIC™ 1100 as needed.
  • Closure of the defect with a synthetic absorbable suture such as size 0 Vicryl-Plus suture, with CT-1 needle. 
  • All trocars are removed and a synthetic absorbable suture such as 4-0 Vicryl Plus suture is used to close the trocar sites.