Open myomectomy using ovarian clamps (triple tourniquets)

If fibroids are large and/or numerous, the only option which removes the fibroids but conserves the uterus is open myomectomy, that is myomectomy done via an abdominal incision (laparotomy). We routinely use a modified technique of "triple tourniquets" to reduce intra-operative blood loss:

a. A cable tie is passed around the cervix is used to occlude the uterine arteries.
b. The new Ovarian artery clamps are placed medial to the ovaries to occlude the ovarian arteries.

The ovarian artery clamps were designed at the Royal Free Hospital specifically for use at open myomectomy to allow the ovarian vessels to be occluded without compromising the ovarian blood supply during surgery (as is the case with conventional tourniquets placed laterel to the ovaries) or damaging the fallopian tubes (as would be the case if conventional tourniquets were to be applied medial to the ovaries).