Our Summary

This study looked at two types of procedures used to remove uterine fibroids: gasless single-port access (SPA) laparoscopic myomectomy using a J-shaped retractor, and conventional SPA laparoscopic myomectomy. A total of 60 patients who had one of these procedures between January 2016 and August 2019 were studied. Half of the patients had the gasless procedure and the other half had the conventional procedure.

The researchers found that there were no significant differences in age, weight, number of previous pregnancies, previous abdominal surgery, and size of the fibroid between the two groups. The time it took to set up the retractor in the gasless procedure was around 8 minutes. The total operation times for both procedures were also similar, with the gasless procedure taking around 105 minutes and the conventional procedure taking around 110 minutes.

The amount of blood loss during the procedures was also similar. None of the patients in either group had to have their procedure converted to a more invasive surgery, and there were no major complications like injuries to the urinary tract, bowel, or blood vessels.

In conclusion, the study found that the gasless procedure using a J-shaped retractor is a safe and effective option. It allows for easy and convenient stitching of the uterus after the fibroid removal.

FAQs

  1. What were the two types of procedures studied for the removal of uterine fibroids?
  2. Were there any differences in the outcomes or complications between the gasless and conventional myomectomy procedures?
  3. How does the gasless procedure using a J-shaped retractor compare in terms of operation time and blood loss to the conventional procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss the different types of procedures available, such as gasless single-port access laparoscopic myomectomy using a J-shaped retractor versus conventional laparoscopic myomectomy. It’s important to understand the potential benefits and risks of each procedure in order to make an informed decision about which option may be best for you. Additionally, it’s important to follow your doctor’s post-operative instructions closely to ensure a successful recovery.

Suitable For

Patients who are typically recommended for myomectomy are those who have symptomatic fibroids causing heavy menstrual bleeding, pelvic pain, pressure, or infertility. Patients who wish to preserve their fertility and avoid a hysterectomy may also be recommended for myomectomy. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if myomectomy is the best course of action for them.

Timeline

Before the myomectomy:

  • Patient consults with their healthcare provider about symptoms and treatment options for uterine fibroids.
  • Patient undergoes pre-operative testing, such as blood work and imaging studies, to assess the size and location of the fibroids.
  • Patient discusses the risks and benefits of the myomectomy procedure with their healthcare provider.
  • Patient schedules the myomectomy surgery and prepares for the procedure according to their healthcare provider’s instructions.

After the myomectomy:

  • Patient wakes up in the recovery room following the procedure.
  • Patient may experience some pain and discomfort in the pelvic area, which can be managed with pain medication.
  • Patient is monitored for any complications, such as excessive bleeding or infection.
  • Patient is discharged from the hospital within 1-2 days after the procedure, depending on the type of myomectomy performed.
  • Patient follows up with their healthcare provider for post-operative care and monitoring.
  • Patient may experience improvements in symptoms related to uterine fibroids, such as heavy menstrual bleeding and pelvic pain, in the weeks and months following the myomectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy include:

  1. What are the benefits of a gasless single-port access (SPA) laparoscopic myomectomy using a J-shaped retractor compared to a conventional SPA laparoscopic myomectomy?
  2. What is the expected recovery time after a gasless myomectomy using a J-shaped retractor?
  3. Are there any specific risks or complications associated with the gasless procedure that I should be aware of?
  4. How long will the procedure take, and what is the expected length of hospital stay?
  5. Will I be a good candidate for the gasless myomectomy procedure based on the size and location of my fibroids?
  6. What type of anesthesia will be used during the procedure?
  7. How long will it take for me to resume normal activities after the surgery?
  8. Will I need to follow any specific post-operative care instructions or restrictions?
  9. What is the success rate of the gasless myomectomy procedure in terms of fibroid removal and symptom relief?
  10. Are there any alternative treatment options that I should consider before deciding on a myomectomy?

Reference

Authors: Hwang JH, Kim BW. Journal: Surg Laparosc Endosc Percutan Tech. 2020 Aug;30(4):356-360. doi: 10.1097/SLE.0000000000000794. PMID: 32788566