Myomectomy using laparoscopic approach offers patients reduced abdominal scars, better post surgical rehabilitation. However, bleeding control may pose a challenge in spite of techniques already described [1Barbosa P.A., Villaescusa M., Andres M.P., Fernandes L.F.C., Abrão M.S. How to minimize bleeding in laparoscopic myomectomy Curr Opin Obstet Gynecol 1 août 2021 ;  33 (4) : 255‑61

Cliquez ici pour aller à la section Références,2Fava V., Gremeau A.S., Pouly J.L., Chauvet P., Gałczyński K., Botchorishvili R., et al. Laparoscopic Myomectomy in 10 Steps J Minim Invasive Gynecol 2019 ;  26 (6) : 1009‑10

Cliquez ici pour aller à la section Références]. Our objective is to show a reproducible technique of bleeding control during mini invasive myomectomy.

We performed a mini-invasive myomectomy using with robotic surgery, with Da Vinci, X. We describe the case of a 35 year-old women, gesta 0 para 0, who presented with menorrhagia, avec pelvic pain, because of a fibroma FIGO 2–5 of 8 cm. She had a desire of pregnancy. We show tips and tricks to control bleeding: (a) two ways of accessing to uterine artery for its occlusion, using either a vascular clamp or a metallic clip; (b) sub serous infiltration with 20 mL of xylocaine with 1% adrenalin, diluated in 100 mL of NaCl serum using a oocyte punction needle; (c) suture with barbed suture. Blood loss was <200 mL.