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Watch this detailed surgical demonstration of Laparoscopic Myomectomy performed on a pedunculated myoma using the innovative Mishra’s Knot technique. This minimally invasive procedure highlights advanced laparoscopic skills, ensuring precise removal of fibroids while minimizing blood loss and recovery time.

In this video, Dr. R.K. Mishra demonstrates:
Step-by-step laparoscopic removal of pedunculated myoma
Use of Mishra’s Knot for safe and efficient suturing
Tips for reducing operative complications and improving patient outcomes

This video is ideal for gynecologists, laparoscopic surgeons, medical students, and healthcare professionals looking to enhance their surgical expertise.

Uterine fibroids, also known as leiomyomas, are benign smooth muscle tumors of the uterus. Among the various types, pedunculated myomas are fibroids attached to the uterine wall by a thin stalk, which can sometimes cause pain, pressure, or abnormal uterine bleeding. Surgical removal becomes necessary in symptomatic cases or when fertility preservation is desired.

Laparoscopic Myomectomy: The Minimally Invasive Solution
Laparoscopic myomectomy has revolutionized the treatment of fibroids by providing a minimally invasive approach. Compared to traditional open surgery, laparoscopic procedures result in:

Smaller incisions

Reduced blood loss

Faster recovery

Shorter hospital stay

Challenges with Pedunculated Myomas
Pedunculated myomas pose unique challenges during laparoscopic removal, including:

Risk of torsion or stalk rupture

Difficulty in achieving secure hemostasis

Proper suturing of the uterine wall

Mishra’s Knot: An Innovative Suturing Technique
The Mishra’s Knot, developed by Dr. R.K. Mishra, is a specialized laparoscopic knot designed to provide secure closure with minimal tension. Its advantages include:

Strong and reliable hemostasis

Ease of laparoscopic application

Reduced operative time

Minimal risk of knot slippage

Surgical Procedure Overview

Patient Preparation: The patient is placed under general anesthesia, and laparoscopic ports are inserted strategically.

Identification and Isolation: The pedunculated myoma is carefully identified, and the stalk is isolated to prevent bleeding.

Excision: The myoma is excised with precision while preserving healthy uterine tissue.

Suturing with Mishra’s Knot: The uterine defect is closed using Mishra’s Knot, ensuring strong hemostasis and minimal tissue trauma.

Specimen Removal: The fibroid is retrieved, often using a morcellator, depending on its size.

Postoperative Care: Patients typically experience less pain and can resume normal activities faster than with open surgery.

Advantages of Using Mishra’s Knot in Pedunculated Myoma Surgery

Secure closure of the uterine defect

Minimal intraoperative bleeding

Faster suturing technique

Reduces risk of postoperative complications

Conclusion
Laparoscopic myomectomy for pedunculated myomas using Mishra’s Knot represents a significant advancement in minimally invasive gynecologic surgery. By combining expert laparoscopic skills with this innovative suturing technique, surgeons can achieve safer, faster, and more efficient myoma removal, ensuring better outcomes and quicker recovery for patients.

Knotting and suturing must-learn skills for any laparoscopic surgeon, gynecologist, or urologist. Without knotting skills, one can not expect to perform advanced surgery. Prof. Mishra's Mishra Knot was published in the World Journal of Laparoscopic Surgery in 2007 and since then hundreds of surgeons all over the world is using this knot. CONCLUSION: Extracorporeal Mishra's Knot and Tayside Knot can tolerate better distraction forces and thus have higher median Knot Quality Score scores compared with Roeder's knots.

For more information please contact:
World Laparoscopy Hospital
Cyber City, Gurugram, NCR Delhi
INDIA 122002
Phone & WhatsApp: +919811416838, + 91 9999677788