This video lecture is given by Dr R K Mishra at World Laparoscopy Hospital. The procedure is very safe an effective when performed by a properly trained physician and the technique continues to evolve as new instruments are developed. However, many physicians today still lack the skills necessary to perform myomectomies through the laparoscope and therefore do not offer them to patients.
Laparoscopic myomectomy is a surgical procedure used to remove uterine fibroids (also called myomas) using a laparoscope, a thin tube with a camera and light that is inserted into the abdomen through a small incision. Laparoscopic myomectomy offers several advantages over traditional open surgery, including less pain, smaller scars, and a shorter recovery time.
The procedure is performed under general anesthesia, and typically involves the following steps:
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Small incisions are made in the abdomen, through which the laparoscope and other surgical instruments are inserted.
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The uterus is inflated with gas to create more space for the surgeon to work.
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The surgeon uses the laparoscope to visualize the uterus and identify the location and size of the fibroids.
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The fibroids are removed using surgical instruments, such as scissors or a morcellator, which breaks up the fibroids into smaller pieces that can be removed through the incisions.
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The incisions are closed with sutures or surgical staples.
Overall, laparoscopic myomectomy is a safe and effective option for the surgical management of uterine fibroids, offering several advantages over traditional open surgery, including less pain, smaller scars, and a shorter recovery time.
There are several contraindications for laparoscopic myomectomy, including:
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Large fibroids: Laparoscopic myomectomy may not be appropriate for large fibroids that cannot be removed through the small incisions used in the procedure. In such cases, open surgery may be necessary to remove the fibroids.
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Multiple fibroids: If a patient has multiple fibroids, laparoscopic myomectomy may not be the best option, as it may be difficult to remove all of the fibroids through the small incisions used in the procedure.
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Previous abdominal surgery: Patients who have undergone previous abdominal surgery may not be appropriate candidates for laparoscopic myomectomy, as adhesions or scar tissue may make the procedure more difficult or increase the risk of injury to nearby organs.
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Severe medical conditions: Patients with severe medical conditions, such as heart or lung disease, may not be appropriate candidates for laparoscopic myomectomy, as the procedure requires general anesthesia and can place additional stress on the body.
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Pregnancy: Laparoscopic myomectomy is not typically performed during pregnancy, as it can increase the risk of complications for both the mother and the fetus.
The decision to proceed with laparoscopic myomectomy will depend on a variety of factors, including the size and location of the fibroids, the patient's overall health, and the presence of any contraindications. The risks and benefits of the procedure should be carefully considered, and the patient should be fully informed of the potential risks and complications prior to the surgery.
Laparoscopic myomectomy is a minimally invasive surgical procedure used to remove uterine fibroids (also known as myomas) from the uterus. Here are some of the advantages of laparoscopic myomectomy:
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Faster recovery time: Laparoscopic myomectomy is a minimally invasive procedure that involves small incisions, which results in less postoperative pain and a faster recovery time than traditional surgery. Most patients are able to return to their normal activities within a few days to a week after the procedure.
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Less blood loss: Laparoscopic myomectomy is associated with less blood loss than traditional surgery. This is because the surgeon can use specialized instruments to cauterize blood vessels during the procedure.
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Reduced risk of infection: Laparoscopic myomectomy is associated with a lower risk of infection than traditional surgery. This is because the incisions made during laparoscopy are much smaller, which results in less tissue damage and a lower risk of infection.
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Preserves fertility: Laparoscopic myomectomy can help to preserve fertility. The procedure allows for the removal of uterine fibroids while leaving the uterus intact, which can be beneficial for women who wish to conceive in the future.
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Minimal scarring: The small incisions made during laparoscopic myomectomy result in minimal scarring compared to traditional surgery. This can be particularly beneficial for women who wish to wear revealing clothing or swimwear.
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Better visualization: Laparoscopic myomectomy allows for better visualization of the pelvic organs, which enables the surgeon to remove the uterine fibroids more precisely. This can help to minimize damage to surrounding tissues.
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Reduced hospital stay: Laparoscopic myomectomy is associated with a shorter hospital stay than traditional surgery. This is because the procedure is less invasive and results in less postoperative pain.
In conclusion, laparoscopic myomectomy offers several advantages over traditional surgery. It is less invasive, results in less blood loss, is associated with a lower risk of infection, preserves fertility, results in minimal scarring, allows for better visualization, and is associated with a shorter hospital stay and a faster recovery time. These advantages make laparoscopic myomectomy a preferred treatment option for many women with uterine fibroids.
While laparoscopic myomectomy is generally considered safe, there are some potential risks and complications associated with the procedure. Here are some of the possible complications:
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Bleeding: Although laparoscopic myomectomy is associated with less blood loss than traditional surgery, there is still a risk of bleeding during the procedure. In rare cases, bleeding can be severe and require a blood transfusion or additional surgery.
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Infection: There is a risk of infection associated with any surgical procedure, including laparoscopic myomectomy. This risk can be minimized by taking appropriate measures to prevent infection, such as using sterile equipment and antibiotics.
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Injury to surrounding organs: During laparoscopic myomectomy, there is a risk of injury to surrounding organs such as the bowel, bladder, or blood vessels. This risk can be minimized by using advanced imaging techniques to visualize the area and careful manipulation of the surgical instruments.
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Scarring: Although laparoscopic myomectomy results in minimal scarring compared to traditional surgery, there is still a risk of scarring at the incision sites. In rare cases, scarring can lead to the development of adhesions, which can cause pain and discomfort.
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Anesthesia-related complications: There is a risk of complications related to anesthesia during any surgical procedure, including laparoscopic myomectomy.
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Conversion to open surgery: In some cases, laparoscopic myomectomy may need to be converted to open surgery. This can occur if the surgeon encounters unexpected difficulties during the procedure or if the fibroids are too large to be removed laparoscopically.
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Recurrence of fibroids: Although laparoscopic myomectomy is effective in removing uterine fibroids, there is a risk of recurrence. Women who have had uterine fibroids in the past are at higher risk of developing new fibroids in the future.
It is important to discuss the potential risks and complications associated with laparoscopic myomectomy with your healthcare provider before undergoing the procedure. Your healthcare provider will be able to assess your individual risk factors and help you make an informed decision about the best treatment option for you.
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