SURGICAL TREATMENTS THAT PRESERVE THE UTERUS
Medical management is not the best treatment for all women with fibroids. Because of their symptoms, some women require surgical intervention. For women who want to preserve their uterus for childbearing, a myomectomy may be the answer. During this procedure, the surgeon removes the uterine fibroids and conserves the uterus.
Fibroids may return after 2-3 years, but most women are symptom free for many years.
da Vinci® Robotic Myomectomy
With the da Vinci® Robotic system, your surgeon can perform a myomectomy by making four small incisions each about 1 centimeter in length. The da Vinci® Robotic system gives the doctor the visualization and precision of an abdominal myomectomy, and gives the patient the benefits of laparoscopic surgery. Those benefits include less blood loss, less postoperative pain, and less scarring. Your doctor can determine if this procedure is appropriate for you based on the number, size, and location of your fibroids.
Ochsner Medical Center physicians have a wealth of experience with this procedure. Our center is one of the only in the area to routinely perform robotic myomectomies.
Patients with large or numerous fibroids may need an abdominal myomectomy. The surgeon makes a small incision above the pubic bone and surgically removes the fibroids from your uterus.
Uterine Artery Embolization
Interventional radiologists perform uterine artery embolizations. After you are mildly sedated, the radiologist uses a slender, flexible tube to inject small particles into the uterine arteries that supply blood to your fibroids and uterus. These small particles block the blood flow to the uterus and to the fibroids. Blocking the blood flow causes the fibroids to shrink. While some successful pregnancies have been reported after this procedure, we recommend this procedure only for women who have completed childbearing.
SURGICAL TREATMENTS THAT DO NOT PRESERVE THE UTERUS
Women who are past their childbearing years have other surgical options for fibroid treatment: uterine artery embolization, endometrial ablation, and hysterectomy.
Endometrial ablation is a treatment for heavy, prolonged vaginal bleeding. This procedure destroys the endometrial lining (the lining of the uterus). Most women who have this procedure are satisfied with the amount of bleeding that they have after the procedure. At Ochsner, we can perform endometrial ablations in the office or the operating room as an outpatient procedure.
During a hysterectomy, the surgeon removes your uterus and cervix. Depending on your age and your medical and family history, the surgeon may also remove your ovaries. Hysterectomy is the definitive treatment for fibroids.
Vaginal hysterectomy is a hysterectomy that is performed through the vagina. The surgeon makes no incisions on the abdomen.
Laparoscopic hysterectomies are performed through small incisions, each approximately 1 centimeter in length, on the abdomen. Similar to vaginal hysterectomy, there is less blood loss, less postoperative pain, and less scar tissue when compared to an abdominal hysterectomy. A laparoscopic hysterectomy can be performed even when the uterus is somewhat large.
da Vinci® Robotic Hysterectomy
The da Vinci® Robotic hysterectomy combines the benefits of laparoscopic surgery with the visualization and precision of an abdominal hysterectomy. These advantages allow your surgeon to perform a hysterectomy on an even larger uterus than can be accommodated with traditional laparoscopy.
For very large uteri, an abdominal hysterectomy may be the solution. The surgeon makes an incision on the abdomen and removes the uterus and cervix through the incision.
- Vaginal Hysterectomy