Laparoscopic Surgery For Fibroids In Uterus: A Boon For Ladies

Fibroid is the most common tumor of uterus which is not cancerous in 99% of cases. Fibroid is so common that almost 40-50 percent of females at the age of 40years are found to have fibroid inside. Most of these women are not having any symptoms. But as the size of fibroid increases with time, many of these women, start having symptoms. Now a days we are seeing more of fibroids even in young girls of 16-17 years of age.

Most common symptoms due to fibroids are-

Heavy bleeding during menses, prolonged menses, irregular spotting, inability to conceive (pregnancy), recurrent abortions, frequent urination, constipation, heaviness in lower abdomen, a palpable big hard mass in lower abdomen which is confused with obesity at times. There is risk of conversion to cancer in less than 1 percent cases.

Treatment- long back fibroid was removed by open surgery where a long incision/cut is given on abdomen to remove the fibroid. It is more like a caesarian section which is more painful for the patient, associated with more blood loss, slow recovery of patient, and more dependency on others/relatives after surgery.

Now a days surgical technique and instruments have improved so much that same surgery is being done by laparoscopy (Key-Hole) where very small incision of 10mm is given and complete surgery is performed using camera and better machines. This gives benefit of almost negligible pain after surgery, minimal blood loss, faster recovery and resumption of work, no dependency on relatives after surgery, and no visible surgery mark on abdomen.

Because of its excellent cosmetic effect and no visible scar on abdomen, laparoscopy has proved to be a boon for unmarried girls.

Different treatment options for fibroids-

1. Medical- medicine can be tried to decrease the size of fibroid but it is a temporary method. Fibroid recurs after medicine is stopped. Medicine is given to the patient who are waiting for the surgery in view of some personal problem or very low hemoglobin level.
2. Laparoscopic myomectomy- Removal of fibroid is called myomectomy. Patient who want to retain their uterus for future childbearing or who are young, fibroid removal is the surgery of choice. Uterus stays safe after surgery. We have removed 2.5kg fibroid from uterus by laparoscopy, which is equal to the size of 7month pregnant uterus.
3. Laparoscopic Hysterectomy- for patients who do not want to retain their uterus or who are beyond 40yrs of age with complete family, laparoscopic removal of uterus with fibroid is done so that patient gets complete cure with no recurrence. We have done laparoscopic removal of 2kg uterus with fibroid which was equal to 6 months pregnancy.
4. How to decrease recurrence of fibroid in future- laparoscopic ligation of uterine artery is a technique where blood vessels feeding to fibroids, are blocked. This helps in decreasing recurrence of fibroid to more than 80 percent cases. Uterus keeps on getting its normal blood supply from other vessels and future childbearing is not compromised so she can plan for pregnancy.

Myth about fibroid surgery-

Myth 1- It should be removed by open surgery.

Fact- Advanced surgical technique has made it possible to remove fibroid by laparoscopy. Fibroid is loaded in a bag and then removed from abdomen so that complete removal is ensured.

Myth 2- big size fibroid can not be operated by laparoscopy

Fact- Any size of fibroid can be removed by laparoscopy by expert gynecologist laparoscopic surgeon

Myth 3- laparoscopic surgery is more expensive

Fact- Recovery of woman is much faster after laparoscopic surgery so loss of work is minimal, that leads to overall cheaper price for surgery.

Myth 4- every gynecologist or surgeon removes the fibroids/uterus by laparoscopy

Fact- This surgery needs a proper training so that best results can be given to the patients. So, a gynecologist who is trained in laparoscopic surgery for fibroid is the best choice.

Myth 5- there is higher chances of uterus removal when only fibroid removal surgery is planned

Fact- There is remote possibility for that kind of risk. In fact we have not removed any of the uterus till date for the patient who is planned for fibroid removal surgery. Only fibroid is removed completely.