In this educational video, we present an advanced surgical approach to Laparoscopic Myomectomy for Complex Multiple Fibroids using the Skin-to-Skin Technique. This step-by-step video demonstrates precise dissection, effective hemostasis, and meticulous suturing techniques essential for managing multiple and challenging fibroids through minimally invasive surgery.

The video highlights key surgical steps, including patient positioning, port placement, identification of fibroids, enucleation strategies, and uterine reconstruction. Designed for surgeons and medical professionals, this video offers valuable insights into improving surgical outcomes and enhancing laparoscopic skills.

Advanced laparoscopic myomectomy has become a cornerstone in the management of complex multiple fibroids, offering women a minimally invasive option that preserves the uterus while ensuring effective removal of fibroids. With continuous innovations in surgical techniques, the “skin-to-skin” approach has emerged as a refined concept that emphasizes efficiency, precision, and reduced operative time—from the first incision to the final closure.

Complex multiple fibroids present unique challenges to surgeons due to their number, size, and varied locations within the uterus. These may include intramural, subserosal, and submucosal fibroids occurring simultaneously, often distorting the uterine anatomy. Traditional open surgery, though effective, is associated with increased blood loss, longer hospital stay, and delayed recovery. Advanced laparoscopy, on the other hand, allows for magnified visualization, meticulous dissection, and superior cosmetic outcomes.

The skin-to-skin technique focuses on optimizing every step of the surgical procedure. Preoperative planning plays a crucial role, including detailed imaging such as ultrasound or MRI to map the fibroids. Proper port placement is strategically designed to allow ergonomic access to all fibroid locations. The use of vasopressin injection minimizes intraoperative bleeding, while advanced energy devices ensure precise dissection and hemostasis.

During the procedure, enucleation of fibroids is performed carefully, preserving as much healthy myometrium as possible. Suturing is a critical step in laparoscopic myomectomy, especially in cases with multiple fibroids. Advanced intracorporeal suturing techniques are employed to restore uterine integrity and reduce the risk of postoperative complications such as uterine rupture in future pregnancies.

Morcellation or specimen retrieval is carried out safely, often using containment systems to prevent tissue dissemination. The skin-to-skin approach emphasizes smooth workflow coordination, minimizing unnecessary delays and instrument exchanges, ultimately reducing operative time and improving patient outcomes.

One of the key advantages of this technique is faster recovery. Patients experience less postoperative pain, minimal scarring, shorter hospital stay, and an early return to daily activities. Moreover, preserving fertility remains a significant benefit, making this approach particularly valuable for women desiring future pregnancies.

In conclusion, advanced laparoscopic myomectomy using the skin-to-skin technique represents a significant advancement in gynecological surgery. It combines surgical expertise, modern technology, and patient-centered care to effectively manage complex multiple fibroids. As surgical skills and technologies continue to evolve, this approach is set to become the gold standard for treating even the most challenging fibroid cases with safety, efficiency, and excellence.