Uterine Myomectomy is a gynaecological surgery to remove uterine fibroids while preserving the uterus. Uterine fibroids are the most prevalent benign tumour (common non-cancerous growths) in the female, it usually develops during reproductive years, but they can occur at any age.
Myomectomy surgery can be performed by three different techniques such as open, laparoscopic or robotic, making it an excellent choice for future fertility in women.
Indications of Myomectomy surgery:
Menometrorrhagia (when menstrual bleeding occurs outside the monthly cycle or extremely heavy and/or prolonged periods) result in anemiaPelvic pain and pressureChronic pain in lower abdominal area, pelvic pressure and discomfort with large size uterine myoma seen in ultrasoundUterine myomas or fibroids that are abdominally palpableEnlarging fibroids with the possibility of malignancy (cancer)Ureteral obstructionGestational size greater than 12 weeks and inability to evaluate adnexa (gynaecological organs around the uterus, - ovaries, fallopian tubes and neighbouring connective tissues)Types of Myomectomy surgery
Myomectomy surgery involves the abdominal incision (cut) for the surgical removal of uterine fibroids. Usually, cervix and uterus are left intact.
There are majorly four types of myomectomy, includes:
Open or Abdominal myomectomyLaparoscopic myomectomyRobotic myomectomyHysteroscopic myomectomyAbdominal myomectomy: Abdominal myomectomy is a major surgical procedure, uses a regular abdominal incision for conventional "open" surgery. It is typically performed to remove particularly huge, numerous, or subserosal or intramural fibroids, or when malignancy is suspected.
Laparoscopic myomectomy: Women with fewer subserosal fibroids may be prepared for laparoscopic surgery. Thin scopes with surgical and viewing tools are utilised in laparoscopic myomectomy procedures.
The lower abdomen is first incised four times, once below the belly button, once below the bikini line (around the pubic hair), and once near each hip. Gaseous carbon dioxide is then injected into the abdominal cavity.
Robotic myomectomy: Through this procedure a surgeon's ability to visualize the fibroids and the surrounding tissue, is improved as well as enhanced ability to stitch up the uterus when removing uterine fibroids and reconstructing the uterine wall.
It does this by combining high-definition 3D magnification, robotic technology, and miniature instruments. Small surgical instruments and slim robotic arms can access the uterus through four abdominal incisions.
Hysteroscopic Myomectomy: Myomectomy with hysteroscope is generally performed for submucosal fibroids, the benign growths of the uterus and commonly seen during reproductive age of women.
A hysteroscopic resectoscope is the instrument which can be inserted into the uterine cavity through the vagina and cervical canal for the removal of fibroids. During a standard resection, the fibroid is surgically removed using an electrosurgical wire loop.
Complications of Myomectomy
Myomectomy surgery has low complications. Still, the procedure constitutes a set of unique challenges. The complications are different to various types of myomectomy performed. They also depend on the complexities of the individual cases.
Some f the complications are:
ScarringExcessive loss of bloodRare possibility of hysterectomyPostpartum or Pregnancy complicationsRare chance of spreading a cancerous tumorPACE Hospitals, with its state-of-the-art OT, equipped with AI Robotic Surgery system and world-class advanced 3D HD laparoscopic and laser equipment to perform minimally invasive major and supra-major gynecological surgery offers evidence based and effective myomectomy surgery in Hyderabad. The team of gynaecologists at PACE Hospitals are well skilled with vast experience in handling critical cases of uterine fibroid.
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