Uterine Fibroid Surgery
Surgery for removing fibroids
Fibroids are benign (noncancerous) tumors that consist of swirls of smooth muscle in the uterus. They can vary greatly in size, number and location within the uterus. As many as 20-30% of women may have fibroids. It is more common to develop fibroids as women get older and fibroids do tend to run in families.
There are two surgical approaches to remove fibroids using a minimally invasive approach:
When 50% or more of the volume of the fibroid is within the uterine cavity, it can be removed using a hysteroscope which is an instrument inserted through the cervix.
- Under general anesthesia, the fibroid is removed in small pieces under direct view of the hysteroscope. No incision is made.
- Patients go home the same day and can typically return to work the next day.
- Patients are seen for follow-up 1-2 weeks after surgery and then again one month later.
- Follow-up testing such as a hysterosonogram or a mid-cycle ultrasound to assess the endometrial thickness and healing are often recommended.
- Fertility is restored within 1-2 months
Fibroids that are primarily in the wall of the uterus or have less than 50% volume within the uterine cavity are removed with a laparoscopic approach.
- Under general anesthesia, four to five very small incisions are made in the abdomen. Under view of the laparoscope, an incision is made in the uterus. The fibroids are shelled out whole and then dissected into smaller pieces and removed through the small incisions. The defect in the uterus where the fibroid was located is sutured and the defect is closed; the incision is much like that of a Cesarean section.
- Patients are kept overnight and discharged the next day.
- Home care and oral pain medications are needed for the next 3-5 days and most patients can return to work within one week.
- Depending on the size and number of fibroids, the uterus takes 2-3 months to heal. Dr. Willman will see patients one week after surgery, and again one month and two months later. Additional follow-up may or testing may be recommended based on each individual patient’s needs and other fertility factors.
da Vinci Surgery which uses robotic assistance with laparoscopy has enabled more patients to become candidates for this minimally invasive laparoscopic approach. Even large fibroids and multiple fibroids can be removed with this new surgical tool. The major benefit for the patient is a quick recovery, but other benefits include less blood loss, and lower risk of scar tissue forming around the fallopian tubes and ovaries.
Experience does count in surgery in order to reduce recurrence of disease. The more experienced the surgeon, the more likely she will recognize and skillfully remove all disease, reducing the risk of recurrence.