Myomectomy
What is Myomectomy?
Myomectomy is a surgical procedure for removing the fibroid while keeping the uterus intact. Most women go for myomectomy when they wish to preserve their uterus for childbearing.
Fibroids are very common with 4/ 10 women developing a fibroid in their lifetime. Fibroids are almost always benign. It is extremely rare for fibroids to have malignant changes.
Of course, there are risks such as the fibroids may recur. Often times fibroids can be very very small and cannot be visible at the time of surgery. If the patient chooses to keep her uterus, later down the road, she may develop new fibroids that can cause a problem.
Hysteroscopic myomectomies are done through the vagina for fibroids within the cavity of the uterus. These patients go home the same day and may return to work after two days. Larger fibroids and those in or outside of the uterine body may be removed laparoscopically or robotically. These are small incisions and patients also go home the same day and feel much better after a week. Much larger fibroids may need an open myomectomy and these patients may need a overnight stay in the hospital for 1-2 nights and 4 weeks for full recovery.
Recovery after Myomectomy:
Fibroid surgeries are usually done through small incisions laparoscopically or robotically. But if patients have very large fibroids, they may need a open myomectomy. With an open myomectomy, patient may stay in the hospital one or two nights. Laparoscopic or robotic myomectomies are usually discharged the same day.
How is Myomectomy done?
There are different methods to perform a myomectomy:
- Abdominal Myomectomy: For many many years, doctors have been doing surgery through a bikini cut or an open procedure through the abdomen. But this procedure generally takes the patient longer to recover.
- Hysteroscopic Myomectomy: The fibroids can be removed by hysteroscopic removal. In this procedure a camera is placed into the uterus through the vagina. The fibroids which are submucous or very superficial just adjacent to the lining can be removed this way.
- Laparoscopic Myomectomy: Then we have laparoscopic myomectomy which is a procedure done by making small incisions in the abdomen and inflating the abdomen with carbon dioxide. After the incision is made, the doctors then put ports into the uterus through the incisions and the surgery is done.
- Robot-assisted Laparoscopic Myomectomy: What’s the most exciting development is robot-assisted laparoscopic myomectomy which is the same as laparoscopic myomectomy but it’s just done with the aid of a robot. By using this technology the doctors have a better control over the tissue and they are able to sew better. The patient through this technique experiences less pain, less bleeding and less disability after surgery and can return back quickly to her normal life.
Results:
Removal of fibroids can help achieve pregnancy. It can also help decrease bleeding.