New surgical technique of laparoscopic resection of adenomyosis under real-time intraoperative ultrasound elastography guidance: A case report

• Main Authors: Yoshiaki Ota, Kuniaki Ota, Toshifumi Takahashi, Soichiro Suzuki, Rikiya Sano, Mitsuru Shiota
• Format: Article
• Language: English
• Published: Elsevier 2020-08-01
• Series: Heliyon
• Subjects: Abdominal surgery; Gynecology; Medical imaging; Pregnancy; Reproductive system; Adenomyosis
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405844020314729

Detecting adenomyosis in the myometrium is a challenge since it is infiltrative with ill-defined margins and can be often confused with uterine fibroids. However, recent advances, such as ultrasound elastography, have enabled its detection in the myometrium, thereby facilitating its accurate diagnosis. We report our experience of performing complete laparoscopic resection of adenomyosis under real-time ultrasound elastography guidance in a 32-year-old woman who underwent laparoscopic adenomyomectomy following severe dysmenorrhea and heavy menstrual bleeding. Real-time ultrasound elastography was also utilized intraoperatively to detect residual adenomyosis. Complete adenomyosis resection and uterine reconstruction were achieved. Follow-up magnetic resonance imaging was conducted to confirm successful uterine reconstruction. The patient recovered rapidly with no complications. Intraoperative elastography-guided laparoscopic adenomyomectomy was feasible and effective in completely removing adenomyotic lesions.