20 x 18 cm Lateral Wall Isthmic Fibroid

TREATMENT (PLAN OF SURGERY) :- Lap. Myomectomy Lap. Myomectomy done under general anaesthesia given by Dr. Amit and done by Dr. Pravin Kanani. LAPROSCOPY: - 10/5 MM primary trocher insersion done. - 3 5mm secondary trocher insersion done under guidance of primary trocher. - Adhesion of omentum with lateral wall of uterus . - Adhesiolysis done with scissor or covidion knife. - No adhesion, no endometriotic spot. - Fibroid removal done and closer with vicryl no 1(2347) done. - Endometriotic spot, fulguration done at OF, U/S lifament. - Uterus :- Size - Enlarge ; Position - Mid position ; Appearance - Congested. - POD :- Oblitarated - Right tube :- Appearance - Normal ; Fimbrial end - Normal - Left tube :- Adherent with Lat. wall of uterus ; Adhesiolysis done. - Right ovary :- Size - Normal ; Position - Normal ; Appearnce - Normal. - Left ovary :- Chocolate cyst seen , Exicion done. OPERATIVE NOTES :- -Big 20 x 18 cm Lal .wall isthmic fibroid seen. - Inj Vasopressin given at site of fibroid. - Incision done by hook needle. - Enuclealion of fibroid done by myoma screw. - Left cornual , broad, U/S ligament cutting done. - Left salpingo-oopharectomy done. - Uterine cavity closer done by V lock. - Fibroid removal done by POD. - POD closer done by vicryl no.1 - Fulguration done at site of slight bleeders. - Uterine fibroid material send for HPE.