Minimally Invasive Surgery for the Removal of Fibroid Tumors and Restoration of the Uterus
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What are uterine fibroids? Fibroids (also called myomas or leiomyomas) are the most common benign tumor of the uterus. Medical science has not yet identified the cause(s) of fibroids but there appears to be a genetic predisposition with many female family members. In a woman's lifetime, one out of every three women will develop a fibroid. Though most women who have fibroids will never need treatment, the treatment of fibroids is the most common reason for gynecological surgery. The good news is that over 98% of uterine fibroids are benign (not cancer). |
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How do fibroids form?
The uterus is composed of muscle fibers that form an inverted pear shaped organ with the ability to shed the internal lining and expand to carry a pregnancy. Individual muscle fibers aberrantly replicate themselves to form a ball of solid fibers called a fibroid tumor. The fibroids have several cellular types and patterns of degenerative changes. Fibroids are classified into 3 different locations:
- Serosal (attached to the outer surface)
- Intramural (within the wall)
- Submucosal (attached to the inner lining)
Who needs treatment?
In general, we attempt to ignore the presence of fibroids since the majority is benign and tolerable to live with. The main reasons for a woman to need treatment for fibroids include: excessive size and other organ impingement, pelvic pain, heavy bleeding, or a history of miscarriages or infertility. The decision to treat fibroids is a detailed individual assessment and cannot be generalized for all women.
Why Laparoscopic Myomectomies?
Traditionally, a myomectomy was performed through an open abdominal incision called an exploratory laparotomy, and for certain cases, this approach is still needed. With the advanced tools and equipment available to your doctors, most patients with problems due to fibroids can have the tumors removed and the uterus excellently repaired using laparoscopic techniques. The national experience supports our experience with many patients having successful and uncomplicated pregnancies after laparoscopic myomectomies.
What are the advantages?
A laparoscopic myomectomy is a same day surgery with several small incisions and a much faster postoperative recovery. T he risks of fever, adhesion formation and overall postoperative pain during the recovery period are much lower than from a larger open incision, i.e., Laparotomy.
What is the disadvantage?
Although the laparoscopic procedure often is completed in the same amount of time as an open case (1 1/2 - 2 hours), approximately 50% of the cases take 50% more time to perform.
What is the recovery time?
Generally, patients can walk and tolerate a clear liquid diet hours after surgery. Almost all patients go home several hours after surgery and take pain medications for days to a week afterwards. Most patients take one or two weeks off work afterwards.
What are the risks?
As with all surgery, there is a risk of bleeding, infection and damage to other organs, as well as the risk of anesthesia. There is also the real chance that after looking inside with a laparoscope that the surgeon will make the decision that the procedure must be converted to an open procedure (laparotomy). We have a detailed consent form for patients to review prior to any decision. Please be aware that as long as you have a uterus, there is a real lifetime risk of recurrence of fibroids.
Insurance Coverage
Laparoscopic myomectomy is a covered surgical option. As with any test, visit or procedure, it is the patient's responsibility to confirm coverage and obtain prior authorization before the procedure can be done. Our scheduler and business office staff is available to assist you.
