Myomectomy

A myomectomy is a surgical procedure to remove uterine fibroids, also known as leiomyomas. The goal of the procedure is to eliminate symptoms such as heavy menstrual bleeding, pelvic pressure, and pain caused by the fibroids.

Types of Myomectomy

• Abdominal Myomectomy: This is an open surgery where a surgeon makes an incision in the abdomen to access the uterus and remove the fibroids.
• Laparoscopic Myomectomy: This is a minimally invasive procedure where a surgeon uses a laparoscope (a thin, lighted tube with a camera) to visualize the uterus and remove the fibroids through small incisions in the abdomen.
• Robotic-Assisted Laparoscopic Myomectomy: This is a type of minimally invasive surgery that uses a robotic system to assist the surgeon in removing the fibroids.
• Hysteroscopic Myomectomy: This procedure involves inserting a hysteroscope (a thin, lighted tube with a camera) through the vagina and cervix to remove fibroids that are located inside the uterine cavity.

Indications for Myomectomy

A myomectomy is typically recommended for women who:

• Have symptomatic uterine fibroids, such as heavy menstrual bleeding, pelvic pain, or pressure.
• Want to preserve their uterus and avoid a hysterectomy (removal of the uterus).
• Are experiencing infertility or recurrent miscarriages due to fibroids.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with myomectomy, including:

• Bleeding or hemorrhage.
• Infection.
• Adhesions or scar tissue formation.
• Damage to surrounding organs, such as the bladder or bowel.

Preparation and Recovery

To prepare for a myomectomy, patients may need to:

• Stop taking certain medications, such as blood thinners.
• Undergo pre-operative testing, such as blood work or imaging studies.
• Arrange for someone to drive them home after the procedure and provide support during recovery.

Recovery time varies depending on the type of myomectomy performed, but most women can expect to:

• Stay in the hospital for 1-3 days after an abdominal myomectomy.
• Return to normal activities within 2-6 weeks after a laparoscopic or robotic-assisted myomectomy.
• Experience some discomfort, cramping, and bleeding during the recovery period.

Outcomes and Follow-up

The success of a myomectomy depends on various factors, including the size, location, and number of fibroids removed. Most women experience significant improvement in symptoms after the procedure.

Follow-up care typically includes:

• Post-operative appointments to monitor healing and remove any sutures or staples.
• Imaging studies, such as ultrasound or MRI, to evaluate the uterus and ensure that all fibroids have been removed.