| Discussion in 'All Categories' started by Vinay Ahuja - Nov 10th, 2011 10:16 am. | |
Vinay Ahuja
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Hi My wife has fibroid has large, non tender mass corresponding to 32 week size uterus felt. My query is that can this be operated through laproscopy. Thanks Vinay +91 9871380559 |
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re: Fibroid
by Dr JS Chauhan -
Nov 17th, 2011
8:31 pm
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Dr JS Chauhan
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Dear Mr. Vinay Laparoscopic Surgery is a good option for your wife large size fibroid. Fibroids also called Leiomyomas are the most common benign tumours of the uterus. They can grow to large sizes causing symptoms for example pain in the lower abdomen, heavy bleeding during periods, intermenstrual spotting and pain during menstruation. Till recently, surgery for removal of symptomatic fibroids myomectomy or hysterectomy was the only real treatment option. Fibroids are benign tumors from the uterine wall. Affect approximately 20-30 percent of women within the childbearing age group. Fibroids be asymptomatic throughout a lifetime. Present with excessive bleeding (menorrhagia), pain during the menstrual cycle (dysmenorrhea), a combination of both and frequently an inability to conceive. Types of fibroids Submucosal Intramural Subserosal GnRH therapy Medical therapy to suppress estrogens and shrink fibroids Advantages Decrease in fibroid volume - allow easier resection using less invasive techniques, reduced hemorrhaging and perioperative morbidity. Disadvantages Premature menopause symptoms Osteoporosis Rebound development of fibroids if treatment methods are stopped Hysterectomy Surgical resection of the uterus with or without removal of the ovaries Kinds of hysterectomy Total: remove corpus and cervix Subtotal: supracervical spare the cervix Oophorectomy & salpingectomy: Unilateral or bilateral Procedure subtypes Abdominal Vaginal Laparoscopic assisted vaginal Laparoscopic Robotic Advantages Complete removal of the fibroid Disadvantages Surgical Scar - smaller for laparoscopic procedures General anesthesia Intraoperative and perioperative morbidity Fertility - The patient cannot become pregnant Hot flashes - just with hysterectomy alone Premature menopause - if oophorectomy is also done Abdominal Myomectomy Open surgery for resection / elimination of the fibroid Advantages Uterine conservation in patients who would wish to maintain fertility Disadvantages Surgical Scar General anesthesia Post-operative recovery is slow Intraoperative and perioperative morbidity Recurrence rates of 10-27 percent Laparoscopic Myomectomy Laparoscopic resection / elimination of the fibroid Advantages Less time to recover compared to an open surgery Ideal for pedunculated subserosal and small intramural fibroids Less Pain Early Return to Work Economical due to smaller stay in hospital. |
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