0:00:03.802,0:00:09.855
The first step in myomectomy is skin incision

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so the preferred way of skin incision in myomectomy is

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the transverse lower skin incision which is called the Pfannenstiel type of incision

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usually most of the myomas can be evacuated or delivered with this incision

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but sometimes, if the myoma is very big

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one can do a subumbilical ?? type of incision

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to faciltate an easier evacuation, delivery of the myomatous uterous for surgery

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so on the skin incision, depending on

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the steps of the layer of the skins

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we have to cut the skin

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followed by the subcutaneous tissue,

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followed by the fascia

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and the peritonium X and then we will

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enter into the abdomen

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once we are in the abdominal cavity

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the first step is to palpate for the uterus

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and to identify the number

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and the location of the myomas on the uterus

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then, so widening the skin incision, the surgeon

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along with the assistant, will deliver they myomatous uterus

0:01:22.514,0:01:25.421
uteous outside of the skin, and then

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see or characterize the number and the locations of the myomas