Gynae Laparoscopy: Minimally Invasive Gynecological Procedure

Also known as leiomyomas or myomas, uterine fibroids are non-cancerous, unnatural growths of the uterus that often appear during the childbearing years of a woman's life. They range from microscopic to bulky masses that can change the shape of the uterus or unnecessarily enlarge it. A woman can have either one or multiple fibroids without any predictability. There are also extreme cases where the fibroids increase so much in size that the uterus reaches the rib cage and adds weight.

The catch about uterine fibroids is that they hardly show any symptoms, thereby going undetected most of the time. They are only detected accidentally during a pelvic examination or prenatal ultrasound. If any fibroid is discovered, it is removed through the procedure of Laparoscopic Myectomy.

What is Laparoscopic Myomectomy:

It is the process in which small incisions are made in the abdomen to remove the fibroids from the uterus. It is a minimally invasive process as compared to open surgery. It is performed using a laparoscope, a light, flexible tube with a camera, to provide a clear view of the inside of the patient's abdomen. 

The procedure goes like this: the patient is first given general anesthesia to ensure she is unconscious and free from discomfort throughout the surgery. Next, the surgeon makes small incisions, around half an inch in length, in the patient's abdomen, and then trocars, which are thin, hollow tubes, are inserted through these incisions. These trocars serve as the access point for the laparoscope and the surgeon's instruments. Then, through one of the trocars, the laparoscope is inserted; it provides a magnified image of the abdominal cavity on the monitor, with the help of which the surgeon can locate the position of the fibroid in the uterus and the status of the surrounding structures. Through the trocars, the surgeon inserts specialized instruments that manipulate the uterus and isolate the fibroids; the surgeon might even tilt or lift the patient's uterus to gain better access.

After identifying fibroids, incisions are made on the uterus to expose and remove the fibroids from the uterine wall, that is, by simply cutting them away from the surrounding healthy tissue. The consequent bleeding is minimized by sealing the blood supply to the fibroids. After thoroughly examining the uterus, the incision is closed using sutures or surgical staples.

When to get Laparoscopic Myomectomy:

The decision to get this procedure done depends on a variety of factors, most of which are listed below:

Fibroid characteristics: Factors like the fibroids' size, number, and location play an important role in determining the requirement for this procedure. This procedure is considered only when the largest fibroid is no less than 10 cm in size and the total number of fibroids is less than 5.

The severity of symptoms: If these fibroids are causing lifestyle-altering symptoms like heavy menstrual bleeding, frequent urination, pain, or pressure in the pelvic region, your doctor might suggest you undergo a laparoscopic myomectomy to alleviate these symptoms.

Fertility preservation: Fibroids are the sole cause of infertility in 2-3% of women; thus, opting for this procedure is one of the safest methods of preserving the fertility of those women who seek to conceive in the future.

Alternative to hysterectomy: Women wishing to retain their fertility must avoid a hysterectomy because it completely removes the uterus and thus leaves them no scope of bearing a child.

Failure of medications: If non-surgical methods, for example, hormonal therapy and medication, have already been tested and proved to provide no relief from fibroid-related symptoms, then a laparoscopic myomectomy should be considered.

Benefits of Laparoscopic Myomectomy

Shorter recovery time: As compared to other operations around the uterus, laparoscopic myomectomy results in a much quicker recovery period. The patients can return to their homes and resume normal activities in a shorter time frame. Thereby making this surgery easy to integrate into normal life.

Minimal blood loss: Using the laparoscope allows for a more controllable approach to the surgery. The surgeon can clearly visualize and ensure that the bleeding is stopped as soon as it starts. This also contributes to the quick recovery of the patient post-operation.

Lower risk of complications: Because of the small size of the incisions and reduced tissue trauma, the concern of potential infections and complications is much lower than with open surgery.

Able to remove multiple fibroids: Even if the fibroids are located in various positions, laparoscopic myomectomy allows the surgeon to remove all of them in a single go.

However, as with all other surgical procedures, the concerned patient must first consult a medical practitioner regarding their symptoms and worries. A doctor will best suggest whether they should go through this procedure or not, depending on their weight, allergies, past medical history, and the fibroids' characteristics. Every case is unique, and only a qualified gynecologist is the best judge of the most appropriate way to go about it.

Conclusion

In conclusion, gynae laparoscopy is a highly effective and minimally invasive procedure for various gynecological conditions. With its numerous benefits, including shorter recovery times and reduced scarring, it is considered a safe and reliable option for many patients. As a consultant obstetrician and gynecologist, Dr. Shubhra Goyal specializes in gynae laparoscopy and can provide expert care and guidance. If you require any gynecological treatment, Dr. Shubhra Goyal is available to assist you.

Also Read: Gynae Laparoscopy: Cosmetic Benefits and Smaller Incisions