A temporary suture-loop occlusion technique for myomectomy during cesarean section: initial experience with 50 consecutive cases

To describe a novel temporary suture-loop occlusion technique and report its perioperative outcomes when applied to patient-requested myomectomy for asymptomatic FIGO type 6 fibroids during cesarean section. In this single-center retrospective case series, 50 patients underwent cesarean section with concurrent resection of FIGO type 6 fibroids using this technique. The key steps included: placing a circumferential 0-gauge absorbable suture around the fibroid base and securing it with a single throw; an assistant then maintained continuous traction on the suture ends to occlude the blood supply, followed by blunt enucleation under traction. The median intraoperative blood loss was 400 mL (IQR, 400–500), with a median hemoglobin decrease of 6.0 g/L. No patient required transfusion. The median operative time was 72.5 min. In this retrospective series of asymptomatic patients who chose to undergo myomectomy during cesarean section, the application of a temporary suture-loop occlusion technique was associated with a perioperative blood loss profile that did not necessitate transfusion. These findings describe the feasibility of the technique in this specific context but do not establish its efficacy compared to other methods or support routine myomectomy for asymptomatic fibroids. Prospective studies with separate outcome measures are needed. Importantly, this technique was applied only in highly selected asymptomatic patients who, after extensive counseling, explicitly requested concurrent myomectomy. These findings are descriptive and do not support routine myomectomy for asymptomatic fibroids during cesarean section.