Myomectomy laparoscopy. Indications for surgery
Myomectomy is a surgical method of removing fibroids, which occupies a significant place in modern gynecology. By far the most common and effective is laparoscopic myomectomy. The main advantage of removal of fibroids by laparoscopic method lies in the fact that in the process the operation fails to remove tumors without damaging the uterus itself. Due to the fact that the most important reproductive organ retains its functionality after a laparoscopy woman can become pregnant and bear a child.
What is a uterine myoma?
The primary indications for laparoscopic myomectomy is uterine fibroids. This disease is considered as one of the most common gynecological diseases. According to statistics, uterine fibroids occurs in approximately 50% of women of reproductive age. Many women are not even aware that they develop this pathology, because fibroids often do not have clearly defined symptoms and a woman does not bring any worry. In most cases the disease is detected by chance during ultrasound examination of the pelvic organs.
Fibroids, also called fibroid, is a benign tumor developing in muscle tissues of the uterus. The tumor is benign and in rare cases can degenerate into malignant. Fibroids may take the form of a single node and multiple nodules covering the surface of the genitals and distorting it. Myomatous node can have a variety of sizes – from a few grams to a kilogram. The treatment of gynecological diseases, only online.
The main advantages and technique of myomectomy uterus
One of the major advantages of laparoscopic myomectomy is that in the process of surgical treatment is removed directly by the tumor itself, and the reproductive organ remains intact. It is the removal of the myoma node laparoscopic method is the most preferred option for nulliparous women. But in turn, preservation of the uterus has an obvious disadvantage – in this case, it is not excluded the risk of relapse.
We can highlight the following positive aspects of laparoscopic removal of fibroids:
- The minimum level of trauma. As surgical intervention with laparoscopy is carried out without direct penetration into the abdominal cavity, the risk of accidental damage to other internal organs are minimal.
- In this surgical treatment in most cases there is no bleeding.
- Adhesions after laparoscopic treatment method is missing.
- This kind of surgical treatment does not leave on the surface of the abdomen visible seams and rough scars.
- In the process of removal of myoma node, the surgeons do not resort to the amputation of the genitals. Due to this some time after the operation the woman can plan pregnancy and to give birth to a child, without resorting to caesarean section. Myomectomy is characterized in that the surface of the uterus remains small scar, which absolutely does not affect the birth process.
- One of the main advantages of laparoscopic myomectomy is considered a short recovery period. In many cases in 4-5 days after the surgery, the woman is discharged from hospital, and sometimes even earlier.
Laparoscopic myomectomy is recommended only in the case if fibroids single or have a small size. In the case of multiple or large in size tumors laparoscopy is not possible because of the high complexity and possible severe complications.
Technique laparoscopy with uterine fibroids is no different from the treatments in other diseases.
- With the help of the trocar anterior abdominal wall is pierced in several places – most often in 4-H. surgery is performed using General anesthesia, so no pain a woman feels.
- In one of the holes introduces a mini-video camera that shows abdominal cavity on the screen of a special monitor, while other holes are used for introducing surgical instruments.
- Before you proceed to direct surgical manipulation, in one of the holes made in the abdominal cavity, is fed carbon dioxide. This is necessary in order to make the work of the surgeon as accurate as possible and comfortable. Carbon dioxide provides the best visualization of the operative field and site of the fibroids, resulting in no risk of inadvertent damage to internal organs with laparoscopic tools.
- Next, surgical instruments are made in the dissection of the uterus and the immediate removal of the myoma node. If the tumors are small in size, they are extracted through openings in the abdominal wall. If the myoma node is large, its removal an incision is made in the lower abdomen or in the vagina. The tumor is dissected into several smaller parts, which in turn is extracted.
- Laparoscopic myomectomy lasts about 1 to 3 hours, depending on the number of nodules and their sizes. After the removal of fibroids on hole sutured.
Contraindications to myomectomy
Laparoscopy uterine fibroids are usually well tolerated by the female body and does not cause severe complications. But, like any other surgery, the procedure has several limitations. Conducting myomectomy is not recommended in such cases:
- If a suspicion of malignancy in any of the internal organs, laparoscopic myomectomy is not possible.
- A contraindication to surgical treatment of uterine fibroids is a severe form of kidney failure.
- Laparoscopic removal of fibroids is contraindicated if a woman has various diseases of the cardiovascular system or the respiratory system.
- When the diagnosis of diabetes mellitus laparoscopy fibroids is not assigned.
- In the case that the node size in uterine tissue more than 10 cm, the laparoscopic myomectomy is performed only after the preliminary course of steroids.
- Obesity is considered a relative contraindication. This means that surgery and removing fibroids site is permitted only after the weight women is normalized.
In the first days after the surgical removal of myoma node, the woman may be administered analgesics narcotic nature. This is done in order to reduce pain, which can be quite pronounced. In some cases, in order to prevent the development of inflammatory or infectious complications, can be prescribed anti-inflammatory or antibacterial drugs. In most cases, after 4-6 days after laparoscopic myomectomy and removal of the node the patient is discharged from the hospital.