Laparoscopic Multiple Myomectomy as a Conservative Alternative to Hysterectomy

Hysterectomy

Every year, more than 600,000 women in the United States undergo hysterectomy, a surgical procedure to remove the uterus. Around 80% of these hysterectomies are performed due to benign (non-cancerous) conditions. Half are due to the presence of benign tumors known as uterine fibroids.

The presence of uterine fibroids is a very common condition that can result in abdominal pain, vaginal bleeding, bloating, and in certain cases decreased fertility.

These "tumors" are generally not cancerous (the incidence of cancer is less than 1%) and are very common in women over the age of 35; however, they are also seen quite often in younger women, especially in those with a family history of this condition.

Although the majority of uterine fibroids could be safely removed while preserving the uterus, this condition still accounts for a large portion of cases where hysterectomy (removal of the uterus) is routinely performed.

Laparoscopic myomectomy (removal of fibroids)

Fortunately, over the last 25 years, laparoscopic surgeons have been gaining more and more experience in the treatment of uterine fibroids.

Our group has been researching, reporting, and teaching Laparoscopic Myomectomy since 1982. Since that time, we have never stopped refining our technique. Our expertise in this field allows many women to conserve their uteruses, even in cases where they have been told that hysterectomy was their only option.

Utilizing video laparoscopy with specially-designed instruments, combined with very precise absorbable intra-uterine suturing, and complemented by our SLAM technique, which allows the removal of large quantities of tissue quickly and without problems, in the great majority of cases we are able to avoid hysterectomy and allow the patient to preserve her uterus.

Many of the earlier concerns regarding improper healing, uterine rupture during pregnancy or delivery, and excessive adhesion formation have proven unfounded.

With careful dissection, meticulous hemostasis, and proper suturing techniques, most patients would benefit from the procedure, irrespective of tumor size, number, and location.

Many hysterectomies presently performed for uterine fibroids can be avoided

Since we are talking about several hundred thousand cases per year in the United States alone, the magnitude of the impact of conservative laparoscopic management over hysterectomy in these patients would be considerable, to say the least.

A small possibility of new tumors and/or residual growth should not discourage the use of Laparoscopic Myomectomy, nor justify hysterectomy as the primary approach.

Why are so many hysterectomies still performed?

Laparoscopic myomectomy is an advanced technique that requires a significant amount of training and skill, as well as expensive specialized equipment, so fewer physicians are available to perform the procedure.

Some hysterectomies are still needed

In cases where the uterus must be removed (such as with certain cancerous and precancerous conditions), the majority of patients could have the operation performed laparoscopically on an outpatient basis – without a large abdominal incision and without an overnight hospital stay.

A true laparoscopic hysterectomy, where the operation is performed completely by laparoscopy, is no small feat. It requires extensive training and years of experience on the part of the operating surgeons and operating room personnel. Our team has been performing, improving, and teaching laparoscopic hysterectomy around the world since 1989. In fact, our group was among the first to perform laparoscopic hysterectomy in an outpatient setting.

Is laparoscopic myomectomy for me?

A certified laparoscopic surgeon is best able to answer that question, after a thorough physical examination and review of your medical records. We have been researching, developing, reporting, and teaching this technique since 1982. During that time we have never stopped refining our technique. Our expertise in this field allows many women to conserve their uterus, even in cases where they have been told that hysterectomy was their only option.

If you have any additional questions or would like to schedule an appointment, feel free to contact our office.

To view a short video of our advanced technique of laparoscopic multiple myomectomy, please click the image below. Please note that our video is being hosted by YouTube.com, and any links to outside content are beyond our control. Their presence on our site does not imply any endorsement on our part.

Alternatives to Hysterectomy Video, Part 1 of 2

 

Alternatives to Hysterectomy Video, Part 2 of 2

 

If you would like more information or an appointment, please contact us.