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Titan-made vascular clips (YASARGIL<jats:sup>\u00ae<\/jats:sup> Aneurysm Clip System) were used to temporarily occlude the bilateral uterine arteries and utero-ovarian vessels. Main outcomes included operating time, blood loss, number of leiomyomas and weight, conversion rate, intra- and postoperative complication rates, and length of hospital stay.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Twenty six patients were included. Dominant intramural uterine fibroid diameters were 9\u201322\u00a0cm. The general characteristics of the patients were similar. The mean surgery duration and intraoperative blood loss were 175.3\u2009\u00b1\u200932.7 (range 120\u2013250) min and 241.1\u2009\u00b1\u2009103 (range 100\u2013450) ml, respectively. The median postoperative drop in hemoglobin was 0.89\u2009\u00b1\u20090.75\u00a0g\/dL. No patient required blood transfusion. No procedure was converted to laparotomy. No major intra- or postoperative complication occurred.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Laparoscopic myomectomy for very large intramural uterine fibroids can be performed safely and effectively, with less intraoperative blood loss, using vascular clips for temporary clamping of the bilateral uterine vessels.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-022-06675-1","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T08:09:58Z","timestamp":1659082198000},"page":"1597-1605","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Use of a microsurgical vascular clip system for temporary bilateral occlusion of the four main uterine vessels for laparoscopic enucleation of very large intramural uterine fibroids"],"prefix":"10.1007","volume":"306","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2414-2671","authenticated-orcid":false,"given":"Shadi","family":"Younes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Radosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Radosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Eichenwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Weisgerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahriye","family":"Aktas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"issue":"2","key":"6675_CR1","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.jmig.2016.11.014","volume":"24","author":"MV Vargas","year":"2017","unstructured":"Vargas MV, Moawad GN, Sievers C, Opoku-Anane J, Marfori CQ, Tyan P, Robinson JK (2017) Feasibility, safety, and prediction of complications for minimally invasive myomectomy in women with large and numerous myomata. 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