Myomectomy is a surgical procedure to make an incision and remove uterine fibroids. The noncancerous cell grows and develops in the uterus. Uterine fibroids usually appear during the reproductive years but can develop at any age.
Our surgeon may recommend a laparoscopic myomectomy to treat fibroids that protrude significantly into the uterus. The surgeon reaches for the fibroids and removes them using instruments inserted through the vagina and cervix into the uterus through telescopic procedure called hysteroscopy if they are present in the most inner wall the uterus. If fibroids are present inside the outer wall of the uterus then they are removed via inserting the telescope inside the abdomin.
Our doctors` primary role in myomectomy is to remove the fibroids that cause symptoms and rebuild the uterus. Unlike a hysterectomy, which removes the entire uterus, a myomectomy removes only the fibroids and preserves the uterus.
Women who have had myomectomy report improved fibroid symptoms, including less heavy menstrual bleeding and lower pelvic pressure, to get pregnent.
Reasons For Laparoscopic Myomectomy
Our doctors recommend myomectomy for fibroids that cause pain or problems or interfere with your normal activities. Here are the reasons to choose myomectomy if you need surgery include:
- You plan to have a baby,
- Doctor`s decision: fibroids can affect your fertility,
- You want to keep your uterus healthy,
What can you expect?
Depending on the fibroids` size, number, and location, our Doctors and Surgeons may choose one of three surgical methods to remove fibroids.
Abdominal myomectomy
In abdominal myomectomy (laparotomy), the surgeon makes an open incision in the abdomen to access the uterus and remove the fibroids. Surgeons generally prefer to make a low-level incision if possible. However, larger uteri require a vertical incision. Abdominal myomectomy is done for large fibroids occupying the whole abdomen.
Laparoscopic Assisted Myomectomy
In all sitution where we do abdominal myomectomy, our expert laparoscopic surgeon can do laparoscopic assisted myomectomy for large fibroids occupying patially or completly whole abdomen and its is laparoscopic assisted myomectomy for large sige fibtoids even in KGs. In laparsocpic assisted myomectomy we use added benefit of telescope to mark blood supply of the uterus and location of fibroid. In laparsocpic assisted myomectomy lead preservation of future fertility vs abdominal myomectmy due to less formmation o scars and adhesions, minimal manupulation fo the uterus tubes and ovaries and better reconstruction of the uterus
Laparoscopic myomectomy.
Our expert laparoscopic surgeon makes a tiny incision in or near the belly button. He then inserts a laparoscope (a thin tube with a camera inside it) into your abdomen. Our surgeons use tools inserted through other small incisions in the abdominal wall. It is the best procedure for those women who want to have future pregnancy with less pain shorter hospital stay and no scaring.
Robotic myomectomy.
Surgeons insert the instruments through small incisions like those used in a laparoscopic myomectomy and then control the movement of the instruments from a separate console.
Sometimes fibroids are cut into pieces (dissected) and removed through small incisions in the abdominal wall. In the procedure use of software for better precision and accuacy of planes for cutting the fibroids from the uterus due to advance zoom in and zoom out automatic control than conventional telescope, but it is costly than laparsocpic myomectomy.
Hysteroscopic Myomectomy:
The surgeon inserts a small, lighted instrument into the uterus through the vagina and cervix. A wire loop resectoscope is usually used to cut (remove) tissue using electricity, or a hysteroscopic resectoscope is used to cut fibroids manually using a blade. Next, a clear fluid, usually sterile saline, is injected into the uterus to widen the uterine cavity and allow inspection of the uterine walls.
Using a resectoscope or hysteroscopic cutter, the surgeon removes part of the fibroid and pulls the pieces out of the uterus until the fibroid is wholly removed. Sometimes larger fibroids cannot be completely removed with one operation and require a second operation.
Preparations for Laparoscopic Myomectomy
- In laparoscopic Myomectomy you will stay in the hospital for only one day or overnight depends on the type of surgery you will have. For example, an abdominal myomectomy (laparotomy) usually requires a hospital stay of 2 to 3 days.
- Our center may ask someone to stay with you on the day of the surgery. Make sure someone is there to help with the move and provide support.
After surgery
After discharge from the hospital, our doctor will prescribe oral pain medication, give you instructions on how to take care of yourself, and suggest your diet and activity restrictions. Depending on your surgery type, you may have a vaginal drip or spot for a few days to six weeks.
Risk
The complication rate of myomectomy is meager. However, the process presents a set of challenges. Many women already have low blood counts (anaemia) due to heavy menstrual bleeding, so they are at increased risk of bleeding problems. Our doctor recommends ways to increase your blood counts before surgery.
During laparoscopic myomectomy, surgeons take extra steps to prevent excessive bleeding. This may include blocking the flow of the uterine arteries with tourniquets and clips and injecting drugs around the fibroids to cause blood vessels to constrict.
Laparoscopic myomectomy may result in fewer adhesions than abdominal myomectomy (abdominal incision).
Strategies To Prevent Potential Surgical Complications
To reduce the risks of myomectomy, our doctor may recommend the following:
- If you have iron-deficiency anaemia due to menorrhagia, Our doctor may recommend iron supplements and vitamins to increase your blood counts before surgery.
- For correcting anaemia, another strategy is hormone therapy before surgery. For example, our doctor may prescribe gonadotropin-releasing hormone (GnRH) agonists, birth control pills, or other hormonal medications to stop or slow your menstrual flow.
- As a treatment, a GnRH agonist suppresses the production of estrogen and progesterone, stops the menstrual cycle, and allows you to rebuild haemoglobin and iron stores.
Fast Treatment, Quick Recovery
In most women, treatment with GnRH antagonists causes menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. However, these inconveniences will disappear after the drug is stopped. Treatment is usually given several months before surgery.
Another class of drugs called selective progesterone receptor modulators, such as ulipristal (Ella), can shrink fibroids and reduce bleeding.
It would help if you fasted (stop eating or drinking) for a few hours before the procedure. Then, follow our doctor`s advice for a specific number of hours.
If you are taking medication, ask our doctor if you should change your usual medication regimen the days before surgery. In addition, tell our doctor about any medicines, vitamins, or other supplements you take.
Ask our doctor what type of anaesthesia you can have.
Finally, discuss pain medications and how you will take them with your doctor.
Outcomes of Laparoscopic myomectomy
Women who undergo laparoscopic myomectomy have good pregnancy outcomes approximately one year after the procedure. However, after a myomectomy, it is recommended to wait three to six months before trying to conceive to allow the uterus to heal.
Fibroids that our doctor doesn`t see during surgery or that aren`t entirely removed may eventually grow back and cause symptoms. Women with only one fibroid have a lower risk of developing new fibroids, often called a recurrence rate, than women with multiple fibroids. In addition, women who became pregnant after surgery were less likely to develop new fibroids than those who were not.
After myomectomy surgery, most women experience relief from troubling signs and symptoms of heavy periods, pelvic pain, and pressure.
Some women with new or recurrent fibroids may choose to have a hysterectomy if they eventually have children.
Feel free to visit our clinic. We are here for your assistance. Our expert laparoscopic gynecologist surgeons will help you test, prevent, and manage your condition. So nothing to worry about when you have a laparoscopic myomectomy because it doesn`t affect fertility. Consult the expert today.