Figure 1

Schematic (A, B, C, and D) and surgical view (E, F, G, and H) of laparoscopic adenomyomectomy using the double-flap method. (A and E) after complete removal of adenomyotic lesions using the resection technique of Osada et al. (B and F) closure and reconstruction of the uterine cavity using 3–0 absorbable suture. (C and G) the first flap in one side wall of the uterus is brought into the second flap in another side of the uterine wall such that the other side wall of the uterus is covered. (D and H) the second flap in another side of the uterine wall is brought to cover the first flap in one side wall of the uterus (before overlapping occurs, the serosal surface of the underlying flaps is stripped to ensure that only myometrial tissue flaps are overlapped).