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Uterine Fibroid Embolization



     

Laparoscopy and Hysteroscopy as Explained by FTG:LA

Laparoscopy and hysteroscopy are minimally-invasive surgical procedures that can be used to remove certain types of fibroids. They are much less drastic than an abdominal myomectomy and since no reproductive organs are removed, future pregnancies may be possible.

Hysteroscopic removal of fibroids requires no incisions at all, and those whose fibroids can be treated by this method often return to work the next day.

There is very little recovery time or pain for those who have a laparoscopy since the incisions are quite small, only about 5mm or not even a quarter inch long.

Laparoscopy

Laparoscopic myomectomy involves the removal of fibroids through instruments inserted through tiny incisions near the abdomen. One incision, in the navel, is used to insert a slim telescope through which the procedure can be viewed by the doctor performing the laparoscopy. Two other incisions, near the pubic line, are used to gently insert the tools that will perform the operation.

Although the incisions are tiny, laparoscopy is still considered surgery and recovery takes about one week for most women.

Those fibroids that are attached to the uterus by stalks, pedunculated myomas, are great candidates for this procedure, as are subserous myomas, which are close to the surface of the uterus. Submucous fibroids, which are deep in the uterine wall, are the hardest to remove through laparoscopy, and it is not always the best choice if there are a large number of fibroids of any type.

After the fibroid is cut from the uterus, it is trimmed into small pieces that can be removed through the tiny incisions. Following their removal, the uterus is repaired and some women are able to leave the hospital that same day. In other cases an overnight stay is recommended, but it is usually possible to walk later that same day, drive the next week, and return to work the week following that.

While some women have been able to conceive and deliver babies after having a laparoscopy, the ability of the uterus to handle all the stress during a pregnancy is still a factor. While some women are able to conceive and carry a child to birth after having their fibroids removed by laparoscopic treatment, not all can do so. Since studies on this are still uncertain, if future pregnancies are desired you should discuss this with your gynecologist, who may decide on a different treatment option.

Hysteroscopy

Unlike a laparoscopy, the hysteroscopic myomectomy can only treat submucosal fibroids, or those that are inside the uterus. This procedure does not require any incisions to be made since the small telescope that is used in the procedure, the hysteroscope, passes through the cervix.

Attached to the telescope, which lets the doctor who performs the hysteroscopy monitor the procedure on a monitor, is a wire attachment through which electricity can pass that is used to cut through the fibroid and cauterizes the wound. The entire procedure typically takes less than an hour, and while anesthetic is necessary to reduce discomfort, the woman is able to return home that same day and can usually resume normal activity, including work and exercise, in one or two days.

Pregnancy rates following a hysteroscopy are good, which makes it an excellent choice if your fibroids can be treated by this method.