Hysteroscopic Myomectomy for Fibroids
What is Laparoscopic myomectomy?
Myomectomy is a surgical procedure of removing uterine fibroids. When done with the help of a laparoscope, it is known as Laparoscopic myomectomy. It is advised for women who experience problems due to fibroids and want the fibroids to be removed without harming the uterus.
Why is Myomectomy done?
Fibroids may cause many symptoms like heavy menstrual bleeding, pelvic pressure, urinary incontinence, difficulty in conception and pregnancy complications. To overcome these issues, doctors may suggest for removal of the fibroid.
Types of Myomectomy Techniques
Several techniques are used to remove the uterine fibroids. The choice of the technique depends on various factors such as the number, location and size of the fibroids as well as few characteristics of the woman. The types of Myomectomy include –
- Laparoscopic Myomectomy: This technique is performed using a telescope like instrument to see inside the abdomen. The procedure involves 3 to 4 very small incisions in the lower belly. Fibroids are removed and the uterus is repaired. Laparoscopy is done under general anaesthesia and recovery time is around 2 to 3 weeks.
- Abdominal Myomectomy: It is the traditional technique for myomectomy where an incision is given in the lower abdominal wall, opening the whole abdomen. It is done under spinal block and full recovery is expected within 4 to 6 weeks.
- Hysteroscopic Myomectomy: Here, a narrow telescope-like instrument, hysteroscope, is passed through the vagina and cervix to visualize the uterus. This procedure is generally useful for a smaller fibroid and submucous fibroid. It is done under general anaesthesia and recovery time is one to two weeks.
How is Laparoscopic Myomectomy performed?
The procedure involves general anesthesia after which the surgeon makes 3-4 small incisions measuring around 0.5cm to 1cm in the lower belly. The belly is filled with carbon dioxide gas so that the surgeon can see inside the abdomen. A laparoscope is then inserted into the abdomen followed by other small instruments. The fibroids are then cut into small pieces and removed from the uterus and taken out from the abdomen via vagina or through small openings in the abdomen. After the fibroids are removed, the instruments are taken out and the gas is released and the incisions are closed.
What to Expect After Laparoscopic Myomectomy?
Women usually require short hospital stay after the procedure. You will be advised to take some antibiotics and painkillers for a few days postop. You can expect vaginal spotting for a couple of days, which is absolutely normal. If you experience heavy bleeding then you need to follow up with your doctor.
Laparoscopic Myomectomy is a minimally invasive procedure after which women have less pain, less blood loss, and can return to normal activity more quickly as compared to open abdominal surgery.
Benefits of Laparoscopic Myomectomy treatment?
Laparoscopic Myomectomy is a safe, effective and appropriate procedure to remove fibroids from the uterus. Some of the benefits are as follows –
- There is less blood loss during the procedure.
- There is short hospital stay and the patient gets a discharge within a day.
- It has a quick postoperative recovery
- There are less chance of intra-op post-op complications like infection and pain.
What are the risks involved in Laparoscopic Myomectomy?
Laparoscopic Myomectomy is a safe procedure with low complication rate. Rarely it may be associated with –
- Excessive blood loss, which is higher with larger fibroid.
- There can be a rare chance of hysterectomy when the bleeding is uncontrollable or if other abnormalities are found in addition to fibroids.
- After surgery, there can be adhesions inside the uterine cavity due to which there can be chances of reduced flow during periods and difficulty in conceiving pregnancy. Chances of adhesion are more in Hysteroscopic myomectomy.
How to prepare before Laparoscopic Myomectomy?
You will be advised to get some baseline investigations done. Then the anesthesia doctor will do a pre-anesthetic checkup. You will be advised to stay empty stomach for at least 6 to 8 hours prior to the surgery. In case you are on any medication, it is preferable to consult the doctor to continue with the medication or not. You will be given some medicines and enema to empty your bowel. Your hair will be shaved off from the lower belly and pubic area.
- Take your medicines as prescribed.
- Do not lift anything heavy until the incision is fully healed.
- Avoid intercourse for at least 6 weeks after the surgery.
- If planning to conceive after the surgery, you should wait for around 3 to 6 months to let the uterus heal fully.
If an experienced surgeon performs laparoscopic myomectomy, it is a safe technique with a good result and an extremely low failure rate. The Best diagnosis and treatment is offered by Dr. Mayuri Kothiwala, who is an experienced surgeon.