This video demonstrates the laparoscopic removal of a large posterior cervical fibroid in a patient who has completed her family but wishes to preserve her uterus.
The procedure begins with assessment of the distorted anatomy and careful retroperitoneal dissection to identify the ureter and uterine vessels.
Blood-loss reduction is achieved using uterine artery control, vasopressin infiltration, and meticulous energy-based dissection.
The surgeon explains how the position of the uterine incision is selected not only for fibroid removal but also to ensure that the defect can be safely sutured afterward.
The large fibroid is progressively enucleated using repeated repositioning of the myoma screw and careful traction-countertraction.
The deep defect is then reconstructed using multiple layers of sutures, including deep box sutures and barbed sutures.
The procedure concludes with contained specimen retrieval, providing numerous advanced surgical pearls for managing difficult cervical fibroids laparoscopically.