Laparoscopic Myomectomy
Indications for surgical management of uterine myoma /fibroids:
- Uterine bleeding is not responsive to treatments
- Suspicion of malignancy
- Pain that affects quality of life
- Urination frequency or tract obstruction
- Anemia related to abnormal uterine bleeding
- Growth after menopause
Laparoscopic Myomectomy:
A surgical procedure to remove symptomatic fibroids through small abdominal incisions while keeping the uterus.
Advantages of Laparoscopic Myomectomy procedure:
- Less blood loss
- Discharge within a day
- Quick recovery
- Reduced scarring
Risks and possible complications:
Low possibility but might include:
- Some cases are advised to deliver by C-section to avoid uterine rupture in case of deep incisions in the uterine wall
- Rare chance of hysterectomy due to uncontrollable bleeding
- Adhesion (rare)
- Need of blood transfusion (rare)
Preparing for the surgery:
- Full history, symptoms assessment and clinical examination
- Ultrasound scan to check the quantity, size and location of fibroids
- Consulting the doctor regarding stopping the the currently used medications or not
- Iron supplementation
- Medications to reduce or eliminate menstrual bleeding
- GnRH agonist therapy is administered to shrink fibroids size and therefore shorten surgery duration, and to improve blood count
The surgery:
- Under General anesthesia
- 3 to 4 incisions are made in the lower abdomen
- A laparoscope is placed inside one of the incisions to see inside the abdomen
- An instrument is used to cut the fibroid into smaller pieces then extracted out through an incision
After the surgery:
- Discomfort is controlled with analgesia
- Light vaginal bleeding and some shoulder pain
Recovery:
- Avoiding lifting heavy objects until the incisions are fully healed
- Check up with the doctor week after the procedure
- Avoiding sexual intercourse for 6 weeks
- Waiting for 3-6 months before trying to conceive
- Can go back to work by 4 weeks
