Our Summary

This research paper is about uterine fibroids, which are benign (non-cancerous) growths in the female reproductive system. These can be managed either by medication or surgery. If medication doesn’t work or if surgery is the first choice, there are various surgical methods that can be used. This paper focuses on minimally invasive surgeries, which are generally preferred because they are less harmful to the body.

One such surgery is myomectomy, which is the standard procedure when the patient wants to retain the ability to have children. It can be done through laparoscopy (small incisions in the abdomen), robotic surgery (using a robot to perform the surgery), or hysteroscopy (using a thin, lighted tube to look into the uterus). The choice of method depends on the characteristics of the fibroids and the surgeon’s abilities.

The paper also talks about mini-laparotomy, which is a less invasive type of surgery that might be as good as the minimally invasive options. The goal of the research is to discuss the latest developments in these minimally invasive surgeries for myomectomy and compare them with the mini-laparotomy method.

FAQs

  1. What is a myomectomy and why is it performed?
  2. What are the different techniques to perform a myomectomy?
  3. How does a mini-laparotomy compare to other minimally invasive myomectomy options?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss the various minimally invasive surgical approaches available, such as laparoscopy, robotic surgery, and hysteroscopy, as these may offer quicker recovery times and less scarring compared to traditional open surgery. It is important to weigh the benefits and risks of each approach with your doctor to determine the best option for your individual situation.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic uterine fibroids and wish to preserve their fertility. Myomectomy is often recommended for patients who have heavy menstrual bleeding, pelvic pain, pressure symptoms, and infertility caused by fibroids. Minimally invasive approaches such as laparoscopy, robotic surgery, and hysteroscopy are preferred for myomectomy in order to minimize postoperative pain, reduce recovery time, and preserve fertility. Mini-laparotomy may also be considered as a less invasive surgical option for myomectomy. The choice of surgical approach depends on the size and location of the fibroids, as well as the skill and experience of the surgeon.

Timeline

Before myomectomy:

  1. Patient experiences symptoms of uterine fibroids such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient undergoes diagnostic tests such as ultrasound and MRI to confirm the presence of fibroids.
  3. Patient discusses treatment options with their healthcare provider and decides to undergo myomectomy for symptom relief or fertility preservation.

After myomectomy:

  1. Patient undergoes pre-operative preparation including fasting and medication adjustments.
  2. Myomectomy is performed using minimally invasive techniques such as laparoscopy, robotic surgery, hysteroscopy, or mini-laparotomy.
  3. Patient may experience some pain and discomfort post-operatively and will be monitored in the hospital for a few days.
  4. Patient is discharged home with pain medication and instructions for recovery.
  5. Patient follows up with their healthcare provider for post-operative care and monitoring of fibroid recurrence.
  6. Patient experiences relief from symptoms and improved quality of life following successful myomectomy.

What to Ask Your Doctor

  1. What are the risks and benefits of myomectomy compared to other treatment options for uterine fibroids?
  2. Which minimally invasive approach would be most suitable for my specific case (laparoscopy, robotic surgery, hysteroscopy)?
  3. How experienced are you in performing myomectomies using the chosen minimally invasive approach?
  4. What is the expected recovery time and post-operative care following myomectomy?
  5. Will my fertility be affected by undergoing myomectomy?
  6. Are there any potential complications or long-term effects to consider after undergoing myomectomy?
  7. How likely is it that my fibroids will return after myomectomy?
  8. Are there any lifestyle changes or medications that can help prevent the recurrence of fibroids after myomectomy?
  9. How often should I follow up with you after myomectomy to monitor my condition?
  10. Are there any alternative treatments or complementary therapies that I should consider in addition to myomectomy?

Reference

Authors: Marín-Buck A, Karaman E, Amer-Cuenca JJ, Lisón JF, Török P, Karaaslan O, Valenti G, Zito G, Biondi A, Chiofalo B. Journal: J Invest Surg. 2021 Apr;34(4):443-450. doi: 10.1080/08941939.2019.1642422. Epub 2019 Jul 19. PMID: 31322011