Myomectomy is a surgical procedure performed to remove fibroids (benign tumors made of smooth muscle cells and fibrous connective tissue) from the uterus while leaving the uterus intact. This procedure is often recommended for women who have symptomatic fibroids and wish to preserve their fertility or retain their uterus.
Different Surgical Approaches for Myomectomy:
- Abdominal Myomectomy: This is the traditional approach where an incision is made in the abdominal wall (either horizontal or vertical) to access the uterus. This approach is typically used for larger fibroids or when multiple fibroids need removal.
- Laparoscopic Myomectomy: In this minimally invasive approach, small incisions are made in the abdomen, and a laparoscope (a thin, lighted tube with a camera) is used to guide the surgeon. Small instruments are inserted through these incisions to remove the fibroids.
- Hysteroscopic Myomectomy: This approach is suitable for fibroids located inside the uterine cavity. A hysteroscope, a thin tube with a light and camera, is inserted through the cervix into the uterus, and the fibroids are removed or shaved off.
- Robotic Myomectomy: Similar to laparoscopic myomectomy, robotic surgery involves the use of a robotic system to enhance the precision of the procedure. The surgeon controls the robotic arms to perform the surgery through small incisions.
When will you be advised Myomectomy?
A myomectomy may be advised in the following situations:
- Symptomatic Fibroids: When fibroids cause significant symptoms such as heavy menstrual bleeding, pelvic pain, or pressure.
- Fertility Preservation: For women who want to preserve fertility and have fibroids that may interfere with conception or pregnancy.
- Large or Multiple Fibroids: When the fibroids are large or there are multiple fibroids that cannot be effectively treated with non-surgical methods.
- Relief of Symptoms: When other conservative treatments have failed to alleviate symptoms, and the fibroids are affecting the quality of life.
Advantages of Myomectomy Surgery:
- Preservation of Uterus: Unlike hysterectomy, myomectomy allows for the preservation of the uterus.
- Fertility Preservation: Myomectomy can be beneficial for women who wish to become pregnant, as it removes fibroids while leaving the uterus intact.
- Symptom Relief: The surgery can provide relief from symptoms such as heavy menstrual bleeding, pelvic pain, and pressure.
Risks Associated with Myomectomy Surgery:
- Bleeding: There is a risk of bleeding during or after the surgery, especially for larger or multiple fibroids.
- Infection: Infection is a potential risk, as with any surgical procedure.
- Scar Tissue Formation: Surgery can lead to the formation of adhesions or scar tissue in the pelvic area.
- Uterine Rupture during Pregnancy: For women who become pregnant after myomectomy, there is a small risk of uterine rupture during labor.
- Recurrence of Fibroids: New fibroids may develop over time, leading to a recurrence of symptoms.
- Adverse Reaction to Anesthesia: As with any surgery, there is a risk of complications related to anesthesia.