Women with a large fibroid or multiple fibroids, or an enlarged uterus often undergo robotic or open procedures at the recommendation of their general practitioner or OB/GYN because they don’t have extensive laparoscopic training. When a doctor tells you that you aren’t a candidate for minimally invasive surgery, it could very well be that it’s not you, but the doctor who isn’t the right fit for the surgery you require.
DualPortGYN and LAAM procedures performed by Dr. Paul J. MacKoul and Dr. Natalya Danilyants at The Center for Innovative GYN Care use the most advanced, minimally invasive laparoscopic techniques. These techniques are far better for the patient than open or robotic procedures. There is less pain, faster recovery, and can be done as outpatient procedures.
LARGE FIBROID PROCEDURES: MYOMECTOMY OR HYSTERECTOMY
There are two surgical treatment options for fibroids:
If you are planning to have children and/or are willing to undergo additional surgeries in the future if the fibroids return, a myomectomy preserves the uterus while removing the fibroids.
The main reason a myomectomy is performed is to preserve the uterus for pregnancy, or to remove fibroids that are preventing the uterus from becoming pregnant. However, removal of fibroids and keeping the uterus will not prevent fibroids from recurring. If fibroids return to the uterus, it could require either another myomectomy or a hysterectomy.
A hysterectomy removes the uterus and the cervix, as well as the fibroids. This is the most definitive treatment for removing fibroids. While the thought of this can be overwhelming, it’s important for women to understand that the ovaries are responsible for making hormones, not the uterus. Removing the uterus will stop menstruation, but it will not begin menopause. If childbearing is not a consideration, a hysterectomy can be the most effective treatment.
CHOOSING A SURGEON
There is often a long standing relationship between a patient and a doctor, and that can have an affect on how a patient decides which surgeon to choose. Unless the patient takes it upon herself to do additional research or get a second opinion, she can face a painful recovery that can last from 6-8 weeks. Complex conditions like large fibroids require the expertise of a GYN surgical specialist. This shouldn’t interfere with your relationship with your OB/GYN. In fact, it’s important to have both.
As the patient, it’s important to know what questions to ask and what answers to expect. In Questions to Ask Your Surgeon we list the most important questions that your surgeon should be able to answer to your satisfaction.