Myomectomy - Making the skin incision

This is part of a video series within a learning module about myomectomy designed for OBGYN residents at St. Paul Hospital Millennium Medical College. This video features an interview with Dr. Malede Birara, Assistant Professor within the Department of Obstetrics and Gynaecology. The full learning moduled is available at http://open.umich.edu/education/med/oernetwork/med/ob-gyn/myomectomy/2013. The video and learning module are shared under a Creative Commons Attribution Non-Commercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/. The video was filmed by Kathleen Omollo from University of Michigan.

The first step in myomectomy is skin incision

so the preferred way of skin incision in myomectomy is

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

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

but sometimes, if the myoma is very big

one can do a subumbilical ?? type of incision

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

so on the skin incision, depending on

the steps of the layer of the skins

we have to cut the skin

followed by the subcutaneous tissue,

followed by the fascia

and the peritonium X and then we will

enter into the abdomen

once we are in the abdominal cavity

the first step is to palpate for the uterus

and to identify the number

and the location of the myomas on the uterus

then, so widening the skin incision, the surgeon

along with the assistant, will deliver they myomatous uterus

uteous outside of the skin, and then

see or characterize the number and the locations of the myomas