LAUSR

OBJECTIVE To introduce an effective approach using laparoscopy in the treatment of upper vaginal leiomyoma. DESIGN Step-by-step video explanation of the surgical procedure with still pictures and surgical video clips to demonstrate the detailed technique, approved by the Shengjing Hospital of China Medical University. SETTING Hospital. PATIENT(S) A 34-year-old woman diagnosed with 5-cm upper vaginal leiomyoma, who had sexual discomfort for 5 years. INTERVENTION(S) Using laparoscopy in the treatment of upper vaginal leiomyoma consists of five steps: first lysing the pelvic adhesion; exploring the pelvic cavity and locating the vaginal leiomyoma through gynecologic examination by the assistant; recognizing the position between leiomyoma and ureter and carefully dissociating ureter while avoiding injury; completely enucleating and resecting the vaginal leiomyoma using laparoscopy; and exploring the ureter, rectum, and uterine artery to make sure there was no injury. MAIN OUTCOME MEASURE(S) Value and feasibility of using laparoscopy in treatment of upper vaginal leiomyoma. RESULT(S) The vaginal leiomyoma was removed successfully using laparoscopic operation and the operative time was 95 minutes. In the follow-up period, the patient did not report any symptoms, and she became pregnant at the time of the 20th month after operation and underwent a vaginal delivery at full-term. CONCLUSION(S) For upper vaginal leiomyoma treatment, laparoscopic operation could present a clear visual field to avoid injury of bladder, ureter, rectum, and uterine artery. Laparoscopic operation is safe and feasible in treatment of upper vaginal leiomyoma.