Our Summary

This study compared two types of laparoscopic surgery used to remove uterine fibroids, a condition known as myomectomy. They looked at the data of 80 patients who had undergone either laparoendoscopic single-site myomectomy (LESS-M) or single-incision plus one port laparoscopic surgery (SILS + 1) between October 2018 and December 2020. They found that there was no significant difference in the basic characteristics or the number, size, and location of fibroids between the two groups. However, the LESS-M surgery was found to be more complicated and took longer than the SILS + 1 procedure. The SILS + 1 procedure also resulted in less blood loss and smaller changes in hemoglobin levels. No serious complications were reported in either group after the surgery. Therefore, SILS + 1 is becoming increasingly popular for myomectomy procedures due to its satisfactory results and shorter operation time.

FAQs

  1. What types of laparoscopic surgery were compared in this study for the removal of uterine fibroids?
  2. What were the main differences found between the LESS-M surgery and the SILS + 1 procedure?
  3. Are there any reported serious complications for either LESS-M or SILS + 1 surgeries?

Doctor’s Tip

A doctor might tell a patient considering laparoscopic surgery that SILS + 1 procedure may result in less blood loss and shorter operation time compared to other types of laparoscopic procedures, such as LESS-M. They may also mention that both procedures have similar outcomes in terms of fibroid removal and recovery, but SILS + 1 may offer some advantages in terms of surgical complexity and time. It’s important for patients to discuss all their options with their doctor and weigh the pros and cons of each procedure before making a decision.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those with uterine fibroids, endometriosis, ovarian cysts, pelvic inflammatory disease, ectopic pregnancy, and other gynecological conditions. Additionally, laparoscopic surgery may be recommended for patients who need a hysterectomy or have fertility concerns. The choice of laparoscopic procedure may depend on the specific condition and the patient’s individual circumstances.

Timeline

Before laparoscopic surgery:

  • Patient undergoes a consultation with a surgeon to discuss the procedure, risks, and benefits
  • Preoperative testing is done to assess the patient’s overall health and suitability for surgery
  • Patient may be advised to stop certain medications or alter their diet in preparation for surgery
  • Patient is instructed on how to prepare for the procedure, including fasting before surgery
  • Patient signs consent forms and discusses anesthesia options with the anesthesiologist

During laparoscopic surgery:

  • Patient is given anesthesia and positioned on the operating table
  • Small incisions are made in the abdomen to insert the laparoscope and other surgical instruments
  • Surgeon performs the necessary procedure, such as removing fibroids or repairing tissue
  • Surgery may last several hours depending on the complexity of the procedure
  • Once the surgery is complete, incisions are closed with stitches or surgical tape

After laparoscopic surgery:

  • Patient is monitored in the recovery room until they are stable
  • Pain medication is provided to manage post-operative discomfort
  • Patient may experience bloating, shoulder pain, or nausea as side effects of the surgery
  • Patient is advised on how to care for their incisions and when to follow up with their surgeon
  • Patient may need to take time off work or limit physical activity during the recovery period
  • Follow-up appointments are scheduled to monitor the patient’s progress and address any concerns

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic surgery for uterine fibroids may include:

  1. What are the potential risks and complications associated with laparoscopic surgery for myomectomy?
  2. How long will the procedure take and what is the expected recovery time?
  3. Will I need to stay in the hospital after the surgery or is it outpatient?
  4. What type of anesthesia will be used during the surgery?
  5. How many incisions will be made and what will the scars look like?
  6. Will I be able to conceive and carry a pregnancy after the surgery?
  7. What type of post-operative care and follow-up appointments will be necessary?
  8. Are there any specific dietary or activity restrictions I should follow after the surgery?
  9. How does the SILS + 1 procedure compare to other types of laparoscopic myomectomy in terms of outcomes and complications?
  10. What is the success rate of the surgery in terms of removing the fibroids and relieving symptoms?

Reference

Authors: Niu G, Zhao H, Wang H, Zhao L, Zhai Y. Journal: J Invest Surg. 2023 Dec;36(1):2221738. doi: 10.1080/08941939.2023.2221738. PMID: 37336518