The procedure done to remove fibroids from the uterus is termed as Myomectomy.
Depending on the size, number and location of fibroids, it can be performed as abdominal myomectomy, laparoscopic myomectomy or hysteroscopic myomectomy. Robotic surgery option is also available at some centres.
PROCEDURE
This surgery is usually performed under general anaesthesia, although some patients may be given a spinal or epidural anaesthesia.
For abdominal myomectomy, a horizontal (bikini incision) or vertical incision (from the navel downward) of 4-5 inches is given. The muscle layers are separated to make an opening in the abdominal wall. On reaching the uterus, each fibroid is excised and removed. All openings of uterus followed by abdominal wall and skin are sutured.
If fibroids are pedunculated and on the outer surface of the uterus, laparoscopic procedure can be performed. A laparoscope is inserted into the pelvic cavity through an incision in the navel. Operating instruments are inserted through small additional cuts to remove the fibroids.
If the fibroids are small and located on the inner surface of the uterus, they can be removed with a thin, telescope-like device called a hysteroscope. The hysteroscope is inserted into the vagina through the cervix and into the uterus. This procedure does not require any abdominal incision, so hospitalization is shorter. Only women with submucosal fibroids are eligible for a hysteroscopic myomectomy. Fibroids located within the uterine wall cannot be removed with this technique.
DURATION
Standard abdominal myomectomy takes 2-3 hours, while laparoscopic/hysteroscopic procedure will take 1-2 hours. Hospital stay of 2-5 days may be needed.
RECOVERY
Patients may need four to six weeks of recovery following a standard myomectomy before they can return to normal activities. Women who have had laparoscopic or hysteroscopic myomectomies, however, can usually recover completely within one to three weeks.
RISKS
- Infection
- Blood loss
- Weakening of the uterine wall, future deliveries may have to be done via caesarean section
- Pelvic adhesions
- Internal scarring (and possible infertility)
- Reappearance of new fibroids