Ovarian artery clamp: Initial experience with a new clamp to reduce bleeding at open myomectomy

Abstract

We studied the effect of novel ovarian artery clamps on intraoperative bleeding in 46 women undergoing open myomectomy for large fibroids. The clamps were applied medial to the ovaries to occlude uterine blood flow from the ovarian arteries without compressing the fallopian tubes, and were used in conjunction with a pericervical tourniquet. Myomectomy was completed successfully in all patients, and an average of 10 fibroids weighing 588 g were removed per patient. The clamps could be applied bilaterally in all but three cases. In the 45 women when at least one ovarian artery clamp was used, the intraoperative blood loss averaged 500 ml, which was comparable with historic data with conventional tourniquets. Ovarian artery clamps appear to be as effective as tourniquets applied to the infundibulopelvic ligaments in reducing bleeding at open myomectomy but have the advantage that they do not occlude ovarian perfusion or crush the fallopian tubes.

Keywords:

• Blood loss
• fibroids
• laparotomy
• leiomyoma
• myomectomy

Acknowledgements

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

The authors are grateful for the help of Downs Surgical of Sheffield, England, for manufacturing the prototype ovarian clamps, and to Sister Hazeley-Wilson and her colleagues in theatre 4 at the Royal Free Hospital for helping with the blood loss measurements.