Myomectomy
Myomectomy is a surgical procedure for removing fibroid tumors from a woman’s uterus. These tumors are also known as leiomyomas. Fibroids consist of smooth muscle and connective tissues rather than cancer cells. They are found on both the interior and exterior of the uterus, in a great range of numbers and sizes. Though rarely malignant, fibroids can be painful and a source of medical problems. Leiomyomas are common in women, though estimates of frequency vary greatly.
Medical science has developed surgical procedures for removing fibroid tumors as an alternative to the hysterectomy. The latter procedure removes portions of a woman’s reproductive system, including the uterus and sometimes the cervix as well. Because a myomectomy eliminates fibroids while leaving the uterus intact, it makes sense for women who:
- Want to retain their reproductive organs
- Would like to get pregnant and have children
- Show evidence of leiomyomas interfering with their fertility
Myomectomies are performed by means of open surgery, minimally invasive laparoscopic surgery, and minimally invasive robotic surgery. In a robot-assisted myomectomy, the medical team uses sophisticated tools that replicate human movement and boost surgical success. Robot-assisted myomectomies are performed at Baptist Health facilities in Kentucky and Indiana.
Who Is a Candidate for a Robot-assisted Myomectomy?
Myomectomies are the surgical means of treating fibroid symptoms for which medications and alternative treatments have proven ineffective. Included among these are:
- Abdominal or pelvic pain
- Bloatedness
- Constipation
- Difficulty getting pregnant
- Discomfort during sexual intercourse
- Heavy menstruation
- Irregular bleeding
- Urinary incontinence
Your physician will determine your suitability for fibroid surgery by analyzing your medical history and ordering a number of tests. These might include bloodwork, an electrocardiogram or EKG, an ultrasound, and a magnetic resonance imaging (MRI) scan. If your condition warrants it, you will be scheduled for a procedure. You will be asked to refrain from eating or drinking for several hours prior to the operation. You may also be required to stop certain medications beforehand.
Many myomectomies are now performed as laparoscopic procedures. This includes robot-assisted myomectomies. Robotic procedures are especially effective when fibroids are few in number or relatively limited in size. Larger fibroids may require an open surgical procedure.
Benefits of Robotic Surgery
It is important to note that a robotic procedure does not mean being operated on by a machine, rather than a fellow human. Robotic procedures are robot-assisted procedures, where the robot is a group of tools used by a surgeon and his or her medical team to aid in an operation. These tools are called robots because they mimic human motions and movements, sometimes with greater precision than we’re capable of.
A robot-assisted myomectomy is a minimally invasive procedure typically involving four minor incisions. It offers these benefits:
- Smaller incisions than with open surgery, and therefore less blood loss
- Reduced scarring
- Lower risk of infection
- Decreased post-surgical pain
- Shorter hospital stays
- Quicker recovery times
- Fewer post-operative complications
- Faster return to normal living
Perhaps most importantly, a robotic myomectomy preserves a woman’s reproductive organs while removing potential obstacles to pregnancy.
How Does Robot-assisted Myomectomy Work?
At Baptist Health, robot-assisted myomectomies are performed with the aid of the Intuitive da Vinci system. Intuitive is a leading American manufacturer of medical robots and related equipment.
The Intuitive da Vinci system has three parts:
- a multi-armed robot for inserting cameras and other surgical instruments in the patient
- a vision cart with endoscopic monitors that provide the surgeon with magnified, real-time images of the surgical site within the body
- a computerized panel from which the surgeon controls the robot and performs the procedure
A robotic myomectomy is conducted similarly to laparoscopic and other forms of minimally invasive surgery. The surgeon makes tiny incisions for the insertion of a three-dimensional camera – the surgeon’s eyes during the procedure – and other operating instruments for the detachment and removal of uterine fibroids. However, a robot-assisted procedure has the advantage of greater precision than a human operating alone because robot technology downscales the surgeon’s hand motions to extremely fine movements, reducing the possibility of organ or tissue damage.
Joining the surgeon and the robot in the operating room are the entire surgical team, including the anesthesiologist, the nurses, and a second surgeon or surgical assistant for moving the robot into positions that aren’t mechanically controlled. A robot-assisted procedure is typically two to four hours in duration.
What to Expect with Robot-assisted Myomectomy
Discuss the procedure with your physician beforehand, including any medically necessary steps prior to coming to the hospital. You’ll be anesthetized and wholly unconscious during the operation.
Following a myomectomy, you’ll remain in the hospital while your vital signs are monitored. Most patients of a robotic procedure go home the same day or after a single night in the hospital. To avoid the possibility of blood clots, you should begin light physical activity shortly after returning home. You may experience some pain following surgery. This can usually be managed with over-the-counter medications. If your pain is severe, or if you have other serious symptoms, contact your physician immediately.
A full recovery from surgery takes two to four weeks. Your sexual activity may be limited for some time while the uterus fully heals. Be sure to schedule a follow-up visit with your physician. If you’re interested in having a child, you’ll want guidelines for when it is safe to start trying to get pregnant.
Know Your Risk
Baptist Health is committed to being a leading medical provider of robot-assisted diagnosis and surgery in Kentucky and Southern Indiana. If you have questions or concerns about your reproductive health, contact your Baptist Health gynecologist.