Laparoscopic/ Open Myomectomy

July 20, 2019

Myomectomy is a surgical procedure which is performed for the removal of fibroid tumors. The first question that comes to our mind after reading this sentence is, what are fibroids?

What are fibroids?

Before getting into the details of the myomectomy procedures, let’s first get to know a little about fibroid, including the definition of fibroids and how they affect our body.

Fibroids also referred to as Myomas are tumors, which are non-cancerous and benign. The aggressiveness (the size and the effect on the body) of the fibroids is classified into three main categories. The four types of fibroids that can persist in a female’s reproductive system are:

  1. Intramural Myoma:

This type of fibroid is the least aggressive one and exists within the muscular wall of the uterus. This fibroid is extremely hard to detect with the naked eyes and requires special tools for the diagnosis.

  1. Subserosal Myoma:

The second category of fibroids, called as the subserosal myoma is a little more aggressive than the subserosal myoma and is not just restricted to the uterus muscular wall. These fibroids spread further and move out of the uterus. Subserosal myoma is often found to be linked to the uterus.

  1. Submucosal Myoma:

It is the fibroid tumor that spreads further and begins to grow beneath the surface of the uterus lining, i.e., inner region of the uterine cavity.

  1. Pedunculated uterine fibroid

The fourth and the last kind of uterine fibroid is pedunculated uterine fibroid which grows on a small stock attached to the inner or outer wall of your uterus.

There are mainly two methods used for the removal of uterine fibroids. These are:

  • Open Myomectomy
  • Laparoscopic Myomectomy

The recovery from any of the myomectomy entirely depends on your immunity, body type and the aggressiveness of the tumor. When the fibroids are small in size, the procedure hardly takes any time and the recovery period is typically less, but if it is taking you longer than others, it is perfectly fine because not everyone’s body isn’t built the same way. Some people have higher immunity than the others and recover faster.

All you have to do, while you recover is let your body be your guide and take your doctor’s advice, very seriously. There are certain measures and precautions suggested after one goes through the procedure of myomectomy. You should consult about these measures with your doctor.

By bringing a certain sort of improvement in your lifestyle can speed up the recovery process. These lifestyle changes involve having a decent routine, getting enough rest, eating a balanced diet, practicing yoga and meditation to get rid of the anxiety and stress, increase the intake of liquid substances, etc. You can ask your doctor, all about these details and he will suggest to you how to go about it and recover from the myomectomy smoothly.

Let’s get to know about these procedures in detail.

Why do fibroids occur?

The doctors haven’t reached any success yet in identifying the exact cause of myomas/fibroids, but the potential causes that lead to the development of fibroids are:

  • Hormonal imbalance

Hormonal imbalance is one of the most common factors that lead to other uterine conditions. PCOS is also a consequence of hormonal imbalance.  The abnormal production of the female reproductive hormones (estrogen) can lead to the development of fibroid tumors.

  • Abnormal changes in the genes

Due to numerous reasons, genes in the uterine region might start to differ from the typical genes and can give rise to fibroid tumor.

Symptoms of fibroids

It is important to seek medical attention when experiencing any of the following discomforts, as it might be an indication towards fibroid tumors.

  • Abnormally heavy menstrual bleeding
  • Irregularity in menstrual cycle
  • Pain in the lower back
  • Pain during sex
  • Need to urinate again and again
  • Expansion of the lower abdomen
  • Complication during pregnancy

All of these symptoms can indicate towards one or more uterine problems and must be discussed with the doctor in order to seek diagnosis and treatment.

Open Myomectomy

Open Myomectomy or Abdominal Myomectomy is one way of removing the uterine fibroids via an incision made in the abdomen.

Detailed procedure

  1. The first step, while performing an abdominal myomectomy is to make an incision across the abdomen. The incision is meant to be horizontal and not vertical.
  2. As soon as the incision is made, there is a need to pull apart the skin so as the doctor can go inside. To accomplish this, a retractor is used. After the skin is separated, you surgeon will get a clear view of your abdominal muscles.
  3. In the third step, the agenda is to reach the uterus and in order to accomplish that, another vertical incision is made on the abdominal muscles. Through this incision, the surgeon can now have full access to your uterus.
  4. As the uterus is visible now, so are the fibroids, the surgeon can now easily operate out the fibroids. To remove the fibroids, your surgeon will take the help of forceps.
  5. In the final step of removal of fibroids, the tissue connecting the uterus and fibroid is removed with utmost care and the fibroid is removed.
  6. The last and the final step is the closure of incisions. This is done with the help of stitches. In the end a sterile bandage is applied to the abdomen.

The procedure of open myomectomy involves certain risks and disadvantages as well, like:

  • Hysterectomy: A situation might arise where the whole uterus might be operated out.
  • Blood loss: Unnecessary amount of blood loss.
  • The bladder and the bowel might get affected

Therefore, Laparsoscopic myomectomy is often preferred over open myomectomy as it overcomes the drawbacks of the open myomectomy and is minimally invasive.

Laparoscopic Myomectomy

The analysis suggests, that in most women, the development of fibroids takes place in their early 20’s. It is not wise to go ahead with hysterectomy in which the, entire uterus is operated out which leaves no options to have children in future. However, there are certain cases in which the size of tumor is the size the uterus and can only be removed through open Myomectomy. Otherwise, if possible, it is better to go ahead with other minimally invasive procedures like Laparoscopic Myomectomy. This procedure only removes the fibroid, leaving in the healthy tissue.

Laproscope allows to perform the procedure of Myomectomy without any such morbid complications like loss of blood, hysterectomy.

Although Laparoscopic myomectomy is preferred over the abdominal myomectomy, but there are certain cases in which the tumor is so aggressive that it can only be treated by Open myomectomy. If the fibroid tumor has progressed to the stage where it has grown equal to the size of your uterus, there might be the need of hysterectomy as well. No matter what treatment plan your doctor decides, as long as the hospital has the right equipment and skilled and experienced doctors, you will be fine and the surgery will proceed with less possibility of complications.

Apollo Cradle Brookefield is one such hospital, to totally rely upon in order to get results with minimum possible complications. The hospital specializes in cases like fibroid tumors and has a decent success rate.

The hospital prioritizes their patient first and makes sure the patient seeks a quality medical assistance with the least amount of discomfort.

How is it done?

The first step, while performing a laparoscopic myomectomy is to make multiple keyhole incisions in the abdomen. After this, when the doctor reaches the uterus, Vasopressin (It causes constriction of the vessels) is injected into the fibroid. Ones the Vasopressin has been injected, the surgery becomes absolutely avascular. The next step is to cut the capsule of the fibroid, and operate out the fibroid. The advantages of this surgery are:

  • It is a bloodless surgery.
  • The uterus is saved.

The procedure only helps in removing the big fibroids. The fibroids that are less than 1 – 2 centimeters are not removed and can grow bigger later.

After your procedure

After your procedure, your breathing tube will be removed and you will be taken to the recovery area for monitoring.

You may be released from the hospital the same day or within one day after the procedure.

It can’t really be decided, which procedure is better because it entirely depends on the type of fibroid you have and how experiences and skilled to perform the surgery. Instead of searching a thousand options, Apollo Cradle Brookefield has narrowed down your options to one. The hospital specializes in the maternity and pediatric procedures. If you are looking forward to myomectomy, you must visit the hospital.

Apollo Cradle Brookefield is one of the best maternity hospitals in Brookefield, Bangalore. They are equipped with the most advanced instruments and technologies that allows them to perform the most complicated procedures with a lot of ease and the least possibility of complications and risks.

The facilities offered at Apollo Cradle Brookfield, are:

  • Emergency care
  • Your Stay
  • Tertiary care, etc. 

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