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Laparoscopic Myomectomy

The surgical removal of fibroids inside the uterus under the observation of a telescope or camera inserted inside the abdomen is known as laparoscopic myomectomy. This is carried out by making small incisions in the abdomen. The procedure is a minimally invasive one and the recovery rate is also generally very high. Laparoscopic myomectomy has been spread widely used in these recent decades as an alternative option to the traditional laparotomy procedure that had some drawbacks like a very long time under the effect of anesthesia and it also consumes a lot of the woman’s time.

The goal of the treatment:

 

Laparoscopic myomectomy surgery majorly aims to preserve the uterus for future pregnancies and maintain the structural integrity of the uterus with a minimum loss of blood.

 

Who needs laparoscopic myomectomy:

 

This is usually done for females with having fibroids. These fibroids may cause a lot of problems in conceiving. Since the laparoscopic myomectomy removes the fibroids while keeping the uterus preserved, it is a great way of getting rid of them.

 

Preparation before the surgery:

 

  • The female should not eat 8 hours prior to the surgery as it might flow back after loosening of the sphincter muscles and block the airway passage under the action of anesthesia.

  • The patient should reach the clinic 3-4 hours before the surgery and get familiar with the environment.

  • Getting a good sleep a night before the surgery is a must.

  • The patient should bring at least one family member along with them who can be there to help them emotionally throughout the procedure.

 

Laparoscopic Myomectomy Procedure:

 

  1. The operation gets started with the doctor inserting a cannula near or in the belly button.

  2. Then the abdomen is filled with carbon dioxide gas to inflate it in order to create more space for operating.

  3. After this, vasopressin is introduced inside the myoma creating transient ischemia.

  4. 3-4 more incisions are then made, and the uterus is incised vertically or horizontally according to the required condition.

  5. Once the opening of the uterine wall is done, the fibroid is exfoliated from the uterus using a myoma screw.

  6. Following the removal of the fibroid, the uterus is then sutured back by firstly stitching the inner wall and then the outer wall.

  7. Then the fibroid is sucked out of the abdomen using a morcellator.

  8. The procedure takes around 2-3 hours if done by a trained and experienced doctor.

 

Laparoscopic Myomectomy aftercare/ Post-operative care and Recovery:

 

  • After the surgery, you can stay in the hospital for a night or get discharged the same day depending upon the assessment of your condition done by your doctor after the procedure has been carried out.

  • If there is any pain in areas such as the lower back and abdomen, then the doctor will prescribe certain medicines.

  • The recovery time for a laparoscopic myomectomy may take a week post the operation which is much lesser compared to that required in the open myomectomy. Hence, the patient can continue with her normal life within a short period of time.

  • Heavy exercises and work requiring major physical effort are strictly contraindicated during the recovery period.

  • Taking healthy diet and proper rest during the recovery period makes sure that you will have a proper healing.

  • Avoid activities like lifting heavy objects or sex during the first two weeks of the surgery. Also, consult the doctor about when it is safe to have sex.

  • Pregnancy can be planned once the uterus has healed completely. The time interval may vary from 3 months to a year depending on the size and the location of the removed fibroid/ fibroids. The time required for attaining full strength of uterus is directly proportional to the size of the scar i.e., as larger scar the on uterus more time will be required for attaining the full strength.

 

Advantages of Laparoscopic myomectomy:

There is not just one but many laparoscopic myomectomy advantages. A few of them are:

  1. The uterus is preserved making it able to carry out further pregnancies after the fibroid(s) is removed.

  2. Fibroids as big as football or even larger in shape can also be removed using laparoscopic myomectomy and that too, without leaving any scar.

  3. The surgery results in minimal loss of blood as compared to other invasive methods.

  4. This surgery is suitable for females having various symptoms caused due to the presence of fibroids like excessive bleeding, pain or even difficulty in conceiving naturally for many years have been able to get rid of such symptoms and conceive, all thanks to this procedure.

  5. Most women are able to successfully get pregnant after laparoscopic removal of the myoma in the uterus.

 

Risks and Complications involved:

The risks and complications involved in a laparoscopic myomectomy are very less as compared to the open myomectomy. You just need to have a competent surgeon by your side who can meticulously remove the fibroids without causing any kind of harm to the uterus and hence, preventing any further complications from happening in the future. Because of the minimal invasion involved in this procedure, it can let you resume your daily activities from just the next day itself without much of a hassle. Although, after this procedure, some people may feel a little pain in their shoulder or back region but that is not a harmful thing for the patient as it can be because of the residual of the Carbon dioxide gas left that was inserted into the abdomen at the time of surgery to increase the accessible space for enhanced visibility. You should know that even though laparoscopic myomectomy has a lot of advantages and sounds like a magical treatment but it also needs to be performed by someone who has a lot of expertise and has ample amount of training and skill to perform this procedure.

 

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