Surgical Excision of Uterine Fibroids: Details on the Procedure, Healing Process, and Potential Risks
Myomectomy is a surgical procedure designed to remove fibroids from the uterus while preserving the organ itself. This approach can alleviate symptoms such as prolonged, heavy periods, cramps, and pelvic pain, and may improve fertility and decrease the risk of pregnancy loss.
Laparoscopic Myomectomy
Laparoscopic myomectomy is a minimally invasive procedure that offers faster recovery times and fewer complications compared to open surgery. In this operation, a small camera is inserted through the belly button, and additional smaller cuts are made in the abdomen to pass surgical instruments through and remove the fibroids.
Typically, patients can expect a hospital stay of 1 day or even same-day discharge if no complications occur. Initial rest lasts a few days to a week, with most patients resuming light activities within 1-2 weeks. Full internal uterine healing takes about 6-8 weeks, although more vigorous exercise, especially abdominal exercises, should be avoided for about a month to prevent complications like navel issues.
Potential complications include conversion to open surgery or hysterectomy, uterine rupture, morcellation-related risks, and longer operative times. However, overall complication rates are low due to the minimally invasive technique.
Hysteroscopic Myomectomy
Hysteroscopic myomectomy is suitable for individuals with fibroids inside the uterus or just beneath the inner lining of the uterus. This procedure involves inserting a camera with attached surgical instruments through the vagina and cervix to remove fibroids inside the uterus.
Recovery times for hysteroscopic myomectomy are generally quick, with patients often discharged within 24 hours. However, the procedure carries specific risks related to uterine instrumentation and fluid absorption, such as excessive fluid absorption leading to hyponatremia or pulmonary edema, injury to adjacent organs (bladder, bowel), excessive bleeding, uterine perforation, and intrauterine adhesions. Preventative measures include the use of anti-adhesion gels or devices post-surgery.
Open (Abdominal) Myomectomy
Open (abdominal) myomectomy involves larger incisions in the abdomen, leading to longer hospital stays and recovery times (several days), with recovery often requiring 4-6 weeks before returning to normal activities. The risks of bleeding, infection, and longer healing times compared to minimally invasive methods are higher.
Additional Considerations
Before undergoing a myomectomy, additional tests such as blood tests, echocardiogram, and imaging scans may be requested to visualize the uterus and fibroids. It's important to note that a myomectomy may not be able to remove all fibroids in a single procedure, and additional surgery may be necessary.
Robotic myomectomy combines high-definition 3D magnification, robotic technology, and small instruments to remove fibroids. A 2018 retrospective study found that robotic myomectomy was suitable for removing large uterine fibroids and had a low complication rate.
For those experiencing symptoms of fibroids and considering future childbirth, a myomectomy may be a suitable option. However, a person who undergoes a myomectomy may later require a cesarean delivery during pregnancy if their rupture risk is higher.
In summary, myomectomy offers a surgical solution for managing uterine fibroids, with laparoscopic myomectomy offering faster recovery times and fewer complications than open surgery, while hysteroscopic myomectomy has specific risks but also a generally quick recovery. The uterus usually heals internally within 6-8 weeks, with full return to all activities taking longer based on the procedure type and individual healing.
- The laparoscopic myomectomy, a minimally invasive procedure, offers faster recovery times and fewer complications compared to open surgery, with patients typically staying in the hospital for 1 day or even being discharged the same day.
- In this operation, a small camera is inserted through the belly button, and additional smaller cuts are made in the abdomen to pass surgical instruments through and remove the fibroids, with most patients resuming light activities within 1-2 weeks.
- On the other hand, open (abdominal) myomectomy involves larger incisions in the abdomen, resulting in longer hospital stays and recovery times, often requiring 4-6 weeks before returning to normal activities.
- Hysteroscopic myomectomy, suitable for fibroids inside the uterus or just beneath the inner lining, carries specific risks like excessive fluid absorption leading to hyponatremia or pulmonary edema, injury to adjacent organs, excessive bleeding, uterine perforation, and intrauterine adhesions.
- For individuals with cancer, or those who are obese, or suffering from other medical-conditions, awareness about the predictive risks and potential complications is essential before undergoing any myomectomy procedure.
- Engaging in fitness-and-exercise and health-and-wellness practices can help manage symptoms of fibroids and improve overall outcomes, especially when combined with regular medical check-ups and monitoring of Women's health.
