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Laparoscopic Myomectomy in Charlottesville, VA

Uterine fibroids, otherwise known as leiomyomas, are non-cancerous growths of the uterus that affect millions of women worldwide. In fact, the lifetime prevalence of fibroids is 70-80% by the age of 50 (Am J Obstet Gynecol. 2003;188(1):100–107). While many fibroids go unnoticed, sometimes the effects can be debilitating. These include heavy menstrual bleeding, pelvic pain, pelvic pressure, and compression of the bladder or rectum. Thanks to advancements in medical technology, treatments like laparoscopic myomectomy offer a minimally invasive solution for women seeking relief from fibroid symptoms while preserving their uterus and fertility.

What is Laparoscopic Myomectomy?

Laparoscopic myomectomy is a surgical procedure designed to remove uterine fibroids while sparing the uterus. Unlike traditional open surgery, which requires a large abdominal incision, laparoscopic myomectomy utilizes small incisions and specialized instruments to access and remove fibroids. This is sometimes done with a ‘robotic platform’ and is referred to as a robotic myomectomy. This minimally invasive approach offers numerous benefits, including shorter recovery times, reduced postoperative pain, and improved cosmetic outcomes.

Benefits of Laparoscopic Myomectomy

  • Faster Recovery: Compared to open surgery, laparoscopic myomectomy typically results in shorter hospital stays, less pain, and quicker recovery times. Our patients usually stay 23 hours in the hospital and many patients return to their normal activities within two weeks, depending on the size and number of fibroids removed.
  • Minimal Scarring: The small incisions used in laparoscopic surgery result in minimal scarring, reducing the risk of unsightly scars, and improving cosmetic outcomes. There is also less scarring where you can’t see it: inside of your abdomen when compared to an open abdominal myomectomy.
  • Preservation of Uterus: One of the most significant advantages of laparoscopic myomectomy is its ability to preserve the uterus. This makes it an attractive option for women who wish to retain their fertility or avoid the need for a hysterectomy, which involves the complete removal of the uterus.

How are Uterine Fibroids Diagnosed?

Diagnosing uterine fibroids involves a combination of medical history, pelvic examination, and imaging tests such as ultrasound or MRI. These tests help determine the size, number, and location of fibroids and are essential for guiding treatment decisions.

Additional Treatment Services For Uterine Fibroids

Laparoscopic myomectomy is not the only treatment option available for uterine fibroids:

  • Medication: Hormonal medications may be prescribed to alleviate symptoms such as heavy menstrual bleeding and pelvic pain. Some hormonal medications can stabilize or shrink fibroids while being taken, but fibroids will grow back when medication is discontinued.
  • Uterine Artery Embolization (UAE): This minimally invasive procedure involves injecting a particulate material into the blood vessels that supply the fibroids, causing a blockage that leads to shrinkage over the course of several months. An interventional radiologist is consulted to perform this procedure usually done through the femoral artery in the groin.
  • Uterine Fibroid Ablation: This procedure is done either laparoscopically or through the vagina using electrosurgical energy to heat up each individual fibroid which leads to fibroid shrinkage. Fibroids do not go away, but volume decreases by up to 50% leading to improved symptom control.
  • Hysterectomy: Fibroids are one of the leading indications for hysterectomy. In severe cases where other treatments have failed or if the fibroids are causing significant symptoms and fertility is not a concern, a hysterectomy may be recommended. This involves the surgical removal of the uterus with all of the fibroids and is a definitive treatment for fibroids.

What To Expect During Laparoscopic Myomectomy

Before undergoing laparoscopic myomectomy, patients will undergo a thorough evaluation to ensure they are suitable candidates for the procedure. This may include preoperative testing, such as blood work and imaging studies, to assess the size and location of the fibroids and ensure there is no elevated concern for cancer.

During the procedure, the patient is placed under general anesthesia and small incisions are made in the abdomen to access the uterus. A laparoscope, a thin lighted tube with a camera, is inserted through one of the incisions to provide a clear view of the uterus and fibroids. Additional instruments are then used to locate and remove the fibroids. The incisions in the uterus are then sutured closed in multiple layers if needed. The Fibroids are then placed in a laparoscopic bag and then removed through a 4 cm skin incision (1.6 inches). Lastly, the skin incisions are closed. After the procedure, patients are closely monitored in the recovery area before being discharged home or admitted for overnight observation. Patients may experience discomfort or pain which is managed with prescribed pain medications.

What are the Risks of Laparoscopic Myomectomy?

While laparoscopic myomectomy is considered safe, like any surgical procedure, it carries some risks. These include:

  • Bleeding: there is a risk of bleeding during and after the procedure which may require transfusion or additional surgical intervention.
  • Infection: infection at the surgical site or within the abdomen is a potential complication of any surgical procedure.
  • Injury to surrounding organs: there is a small risk of unintentional damage to nearby organs, such as the bladder or bowel, during the surgery.
  • Intra-abdominal adhesions: this is common to all surgical procedures, but is reduced with a laparoscopic compared to an open surgery.
  • Fibroid recurrence: in patients with multiple fibroids there is a risk of recurrence or new fibroid growth with any procedure that preserves the uterus.
  • Anesthesia complications: complications related to anesthesia, such as allergic reactions or breathing difficulties, may occur.
  • It's essential for patients to discuss these risks and ensure they understand the potential benefits and drawbacks of laparoscopic myomectomy before proceeding with the surgery.

Why Choose The Center For Advanced Gynecology

The Center for Advanced Gynecology is committed to providing comprehensive care for women with uterine fibroids. Our team of experienced gynecologists specializes in minimally invasive surgical techniques, including laparoscopic myomectomy, and is dedicated to delivering personalized care tailored to each patient's unique needs.

With state-of-the-art facilities and a patient-centered approach, we strive to ensure that every woman receives the highest quality care throughout her treatment journey. From initial consultation to postoperative follow-up, our goal is to provide compassionate support and guidance every step of the way.

Frequently Asked Questions About Laparoscopic Myomectomy

Recovery time varies depending on individual factors such as the size and number of fibroids removed, but most patients can expect to resume normal activities within 2 weeks after surgery.

In most cases, yes. Laparoscopic myomectomy preserves the uterus, making it possible for women to conceive naturally or with the assistance of fertility treatments.

Most women experience relief from fibroid symptoms without long-term side effects. However, it's essential to attend regular follow-up appointments to monitor for recurrence of symptoms or complications.

Laparoscopic myomectomy offers a safe and effective treatment option for women with uterine fibroids, providing symptom relief while preserving fertility and minimizing recovery time. With the support of an experienced and skilled surgeon women can confidently address their fibroid-related concerns and improve their overall quality of life.