Free Medical Advice Related to Laparoscopic Surgery

Fibroid
Discussion in 'All Categories' started by Vinay Ahuja - Nov 10th, 2011 10:16 am.
Vinay Ahuja
Vinay Ahuja
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
re: Fibroid by Dr JS Chauhan - Nov 17th, 2011 8:31 pm
#1
Dr JS Chauhan
Dr JS Chauhan
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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