Fibroids: our strategy

Since fibroids usually grow with time ,we believe that if symptomatic or large they must be removed.

 
Moreover, medical management is only temporary and once stopped, the fibroids continue to grow.

 
Also, we have seen that uterine artery embolisation causes reduction in the uterine blood supply and this may reduce future fertility.

 
Hence, myomectomy (removal of fibroid) is the best method for treating fibroids.

 

Conventionally myomectomy is performed by laparotomy. However, this requires a large incision on the abdominal wall in order to gain access to the uterus and remove the myoma. Most importantly it leads to post operative adhesions which cause pain and impaired future fertility (see also adhesions section on this website. 

Laparoscopic myomectomy using gas is performed in some places, but, there are problems with carbon-dioxide insufflation like post operative pain, much slower recovery and a longer hospital stay (see gasless Lift-Laparoscopy section of this website).

 
Also there are doubts about the lack of strength of the sutures and the subsequent risk of uterine rupture during childbirth.

 
With our technique of gasless lift-laparoscopic myomectomy, we combine the best of both (i.e. laparotomy and laparoscopy): using the Abdo-Lift system and conventional surgical instruments we are able to perform myomectomy with the advantage of much stronger and secure closure of the uterine wall and hence negligible chance of uterine rupture. Since the access is through laparoscopic ports ,the risk of post operative adhesions are usually none.

 
So far we have performed more than 600 gasless lift-laparoscopic myomectomies. 170 patients of these were infertile before surgery and after surgery the pregnancy rate was about 80%. No uterine rupture during pregnancy or childbirth occured.

 
The technique of gasless lift-laparoscopic myomectomy is explained sequentially in the LINKS under surgical results.