WHAT is Laparoscopic Myomectomy?
Myomectomy refers to the surgical procedure of removing uterine fibroids that interfere with normal body functioning and usually develop during childbearing years in women. Laparoscopic myomectomy is one such surgery wherein the uterine fibroids are removed through several small incisions in the abdomen, mostly preferred by patients. In the case of multiple big fibroids, the traditional method of abdominal myomectomy is performed since it allows the surgeon to dissect and remove single or multiple target fibroids in one sitting. The specialist team in our Department of Gynaecology at Yashoda Hospital is highly experienced to treat varied gynaecological conditions using the most advanced techniques and approaches to give you the best treatment.
WHAT are the signs that call for Laparoscopic Myomectomy?
As common as they are, these are some of the symptoms that you may have to which your doctor may recommend the procedure-
- Menstrual period lasting for an unusual amount of days
- Urination problem
- Unusual heavy period
- Lower back pain
- Leg pain
- Pelvic pain
HOW is Laparoscopic Myomectomy done?
Once your symptoms are observed and your doctor is assured that you need a myomectomy, your doctor will take a pelvic ultrasound or even an MRI in order to identify the size and the location of the fibroid in your uterus. In most cases with large fibroids, you will be prescribed certain medications to shrink the fibroids, which reduces the procedure’s duration. Before the medication and the whole surgical process, you must let your gynaecologist know about any kind of medication you are on.
Before the procedure: The surgery is preceded by blood tests which include a pre-anaesthetic check-up while the anesthetist checks on your medical history and asks about any reactions your body may have during the medication. You will be advised to fast for 6-8 hours before the surgery.
During the procedure: After the anaesthesia is administered, your gynaecologist will make 3-4 incisions on the abdomen to access the inside. This incision can be of two types depending upon the size of the fibroids, Bikini-line incision, and Vertical incision.
Bikini-line incision: This is usually done in the case of smaller sizes of fibroids. Here, a horizontal incision is done following your natural skin which causes lesser pain and scarring than in a vertical incision.
Vertical incision: In this case, the incision starts in the middle of the abdomen to the top of the pubic bone. The wider access through the incision is done so due to the need to not only access the larger-sized fibroids but also to navigate easier and reduce bleeding.
After the incision is made, the surgeon will insert laparoscopic instruments through them in order to identify the fibroids. The abdomen is then inflated with carbon dioxide to create space for the instruments to access the inside and an incision on the uterus is made while the surgeon peels out the fibroids through the holes in the abdomen. Bigger fibroids are sliced into pieces using a morcellator. The fibroid pieces are then removed one by one until all of them are completely extracted from the uterus. After the entire process, the surgeon will carefully and firmly stitch up the uterine muscle that had been cut using laparoscopic instruments.
After the procedure: Since laparoscopic surgery is an open surgery, the recovery is fast and with a day’s rest in the hospital, you will be safe to go home the following day. Complete recovery may take as brief as 2-3 weeks. Although the recovery is assured in less than a month, our experts recommend pregnancy after about 3-6 months post-surgery since the stitches inside the uterus take that time to fully heal.
WHAT are the risk factors involved?
Firstly, to ensure a safe laparoscopic myomectomy, the procedure absolutely calls for a skilled and experienced surgeon. Some of the most common risk factors are as follows-
- Infection: Like most major surgery, laparoscopic myomectomy may lead to the development of an infection post-surgery in certain cases which will call for a longer stay in the hospital while being administered antibiotics.
- Blood loss: High risk of excessive blood loss during the surgery demands raising your blood count before the surgery, making women with low red blood cell count due to heavy menstrual bleeding more vulnerable to becoming anaemic.
- Tumours: Although very rare, tumours in the uterus may be mistaken for fibroids and the slicing during the procedure may lead the tumour pieces to spread cancer.
- Organ damage: In certain cases, the procedure may cause injuries to the uterus and the organs nearby such as the bladder or bowel and other urinary systems owing to its close proximity.
- Anaemia: Patients with anaemia have higher risks and doctors usually prescribe iron supplements or other medicines to boost the blood count before the surgery.
WHAT to expect regarding pregnancy post-surgery?
Although chances for vaginal birth reduce after a laparoscopic myomectomy, there have been many cases wherein women gave successfully give vaginal birth provided the best care is given. Post-surgery, your pregnancy may be categorised as ‘high-risk’ but you do not have to worry about it. It will only mean your pregnancy will need extra monitoring and a hospital that is highly equipped to handle high-risk pregnancies to take all necessary precautions. Yashoda is one such hospital you can trust.
WHOM to consult?
As much as a major surgical procedure such as Laparoscopic Myomectomy requires a highly skilled specialist team, you must follow your gynaecologist’s instructions for ensuring the success of the surgery. Our specialised teams in the Department of Gynaecology as well as the Centre for Infertility and IVF at Yashoda Hospital are here to give you up-to-date standards of treatment entirely based on your personal need and condition.
For any query on Hysteroscopic Myomectomy and its procedure, please contact us on our official website www.yashodahealthcare.com, or book an appointment with our Gynaecology/Obstetrics specialists Dr. Sashi Arora and Dr. Gauri Agarwal by calling us on 09810922042.