Prevention of complications is best but when they occur early recognition and prompt and appropriate management are required the surgeon undertaking laparoscopy should be familiar with the equipment being used potential problems that may be encountered and should be able to manage complications. It should cause minimal damage to the endometrium while being tolerable and durable and reduce the incidence of myoma recurrence and complications including bleeding hematoma adhesions and gravid uterus perforation training and experience are crucial to reduce complications the surgical strategy depends on imaging information on the myomas. Laparoscopic myomectomy complications can be intraoperative due to inappropriate hysterotomy enucleation hemostasis and morcellation injuries alternatively the complications may be postoperative due to hysterotomy site hematoma and adhesions pelvic adhesions and recurrence. Prevention and management preoperative correction of coagulation defects excellent visualisation of important structures and careful dissection minimise the incidence of intraoperative bleeding delicate handling of the instruments retracting the spleen is required to avoid bleeding from the spleen
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