Our Summary

This research study is comparing two types of surgery for removing uterine fibroids (myomas), a very common non-cancerous growth in the uterus. The two types of surgery are single port laparoscopic myomectomy and conventional laparoscopic myomectomy. In a single port laparoscopic myomectomy, the surgeon makes one small incision through which he or she inserts a tube with a camera and surgical tools. In the conventional method, multiple small incisions are made.

The researchers looked at multiple studies and analyzed the results. They found that there was no real difference in terms of safety and feasibility between the two types of surgeries. Both types had a similar number of minor complications, and a similar number of cases where a second surgery was required. No patients required a conversion to open surgery (laparotomy).

The only real difference found was that patients who had the single port surgery experienced less pain one hour after the operation. However, this difference was not present six and 24 hours after the surgery. The two types of surgeries had similar operation times, blood loss, and decrease in hemoglobin levels.

The researchers concluded that if the patient is a good candidate for the single port surgery (based on the size and number of fibroids), then it can be a good option with similar results to the conventional method. However, more research is needed to see if there are other benefits to the single port surgery such as better cosmetic results, higher patient satisfaction, or better pregnancy outcomes.

FAQs

  1. What are the two types of surgeries for removing uterine fibroids being compared in this study?
  2. What differences were found between the single port laparoscopic myomectomy and conventional laparoscopic myomectomy?
  3. What are the possible benefits of the single port surgery that researchers suggest require more investigation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss with your surgeon the best surgical approach for your individual case. It is important to consider factors such as the size and number of fibroids, as well as your overall health and preferences. Be sure to ask your surgeon about the potential benefits and risks of each type of surgery, and make an informed decision based on your specific situation. It is also important to follow your surgeon’s pre and post-operative instructions to ensure a successful recovery.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic fibroids that are causing pain, heavy menstrual bleeding, pressure on the bladder or rectum, or fertility issues. The decision to undergo myomectomy is based on the size, number, and location of the fibroids, as well as the patient’s symptoms and desire for future fertility. The type of surgery recommended will depend on the individual patient’s case and the surgeon’s expertise.

Timeline

Before myomectomy:

  • Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination, and infertility
  • Patient consults with a gynecologist who diagnoses uterine fibroids
  • Gynecologist recommends myomectomy as a treatment option
  • Patient undergoes pre-operative testing and evaluation to determine the best surgical approach

After myomectomy:

  • Patient undergoes surgery (single port laparoscopic or conventional laparoscopic myomectomy)
  • Patient may experience less pain one hour after single port surgery compared to conventional surgery
  • Both types of surgeries have similar operation times, blood loss, and decrease in hemoglobin levels
  • Patient is monitored post-operatively for any complications or need for additional surgery
  • Patient may experience relief from symptoms such as heavy bleeding and pelvic pain
  • Patient may need to follow up with gynecologist for further evaluation and management of fibroids

Overall, the patient’s experience before and after myomectomy involves consultation with a gynecologist, surgical evaluation, surgery, and post-operative monitoring and management. The choice between single port and conventional laparoscopic myomectomy may depend on individual factors and preferences, with both options showing similar safety and feasibility in studies.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with both single port laparoscopic myomectomy and conventional laparoscopic myomectomy?
  2. How will the decision be made on which type of surgery is best for me based on the size and number of myomas?
  3. What is the expected recovery time for each type of surgery?
  4. How long will I need to stay in the hospital after the surgery?
  5. Will I need to take any pain medication or other medications after the surgery?
  6. How soon can I return to normal activities, such as work and exercise, after the surgery?
  7. Are there any long-term effects or considerations to keep in mind after having a myomectomy?
  8. Will having a myomectomy affect my fertility or ability to have children in the future?
  9. What is the likelihood of the fibroids returning after the surgery?
  10. Are there any alternative treatment options to consider besides surgery for my fibroids?

Reference

Authors: Lee D, Lee JR, Suh CS, Kim SH. Journal: Eur J Obstet Gynecol Reprod Biol. 2019 Aug;239:52-59. doi: 10.1016/j.ejogrb.2019.06.001. Epub 2019 Jun 3. PMID: 31181399