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. 2022 Aug 18;9:914725. doi: 10.3389/fsurg.2022.914725

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© 2022 Qin, Dong, Tang, Zhang, Wang, Bao, Wei, Shi, Chen and Xia.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Procedure diagram of a transabdominal operation. (A) Inject diluted pituitrin; (B) remove uterine fibroids; (C) make a longitudinal incision of adenomyosis lesions to reach the uterine cavity; (D) Resect the lesion as much as possible (preserving approximately 0.5–1 cm of the plasmomuscular layer flaps); (E) treat the contralateral lesions with the same method; (F) gradually subtract the lesion to the uterine cavity and excise a part of the uterine cavity to reduce the uterine volume; (G) treat the contralateral lesions with the same method; (H) remodel the myometrium; (I) place the LNG-IUS (Manchester ring) and reshape the depth of the uterine cavity again based on the LNG-IUS length; (J) Mattress-suture the uterine cavity continuously; (K) align the sarcoplasmic layers and reduce the extra length; (L,M) suture the bilateral seromuscular layers with the “baseball stitching technique”; (N) repair the sutured uterus; (O) uterine fibroids and adenomyosis specimens resected during the operation.