Bonney's myomectomy clamp is used to temporarily occlude uterine blood vessels, so that there is little or no bleeding while the uterus is cut and leiomyomas within it are removed surgically. It is combined with application of an atraumatic clamp (sponge holding forceps) on each infundibulopelvic ligament to occlude the ovarian blood vessels which anastomose with the uterine vessels and supply blood to the uterus too.
We were performing a myomectomy for a large posterior fundal leiomyoma with encroachment on the upper part of the right broad ligament. Bonney's myomectomy clamp and sponge holding forceps were in place. When we opened the right broad ligament, even tiny blood vessels started bleeding furiously. Conventional methods proved inadequate to stop the bleeding. Then I had an idea. I released the Bonney's myomectomy clamp and sponge holding forceps. The bleeding stopped instantly.
"The clamp was occluding only the uterine veins, while the uterine arteries remained open and continued to pump blood into the uterus. That raised the venous pressure and caused such uncontrollable bleeding by back flow through the injured veins" I explained.
"We have not seen this before" they said.
"Nor have I" I said. "There is always a first time. Lucky for you it happened to someone else, so that you did not have to experience it first hand and try to find a solution to that problem."
We completed the myomectomy without any attempt at occluding uterine blood supply. There was not any hemorrhage.
We were performing a myomectomy for a large posterior fundal leiomyoma with encroachment on the upper part of the right broad ligament. Bonney's myomectomy clamp and sponge holding forceps were in place. When we opened the right broad ligament, even tiny blood vessels started bleeding furiously. Conventional methods proved inadequate to stop the bleeding. Then I had an idea. I released the Bonney's myomectomy clamp and sponge holding forceps. The bleeding stopped instantly.
"The clamp was occluding only the uterine veins, while the uterine arteries remained open and continued to pump blood into the uterus. That raised the venous pressure and caused such uncontrollable bleeding by back flow through the injured veins" I explained.
"We have not seen this before" they said.
"Nor have I" I said. "There is always a first time. Lucky for you it happened to someone else, so that you did not have to experience it first hand and try to find a solution to that problem."
We completed the myomectomy without any attempt at occluding uterine blood supply. There was not any hemorrhage.
