Key Takeaways of Fibroid Removal

• Type: Minimally invasive (Laparoscopic, Hysteroscopic) or Surgical (Open)
• Duration: 30 mins to 3 hours, depending on type
• Anesthesia: General anesthesia
• Recovery Time:
  • Open: 4-6 weeks
  • Laparoscopic: 2-4 weeks
  • Hysteroscopic: Few days

Types of Fibroid Removal

• Anesthesia: The patient is given anesthesia to ensure comfort and minimize pain during the procedure. The type of anaesthesia used depends on the surgical approach and the patient's medical history.
• Accessing the Uterus: The surgeon accesses the uterus through one of several methods, such as open surgery, laparoscopic myomectomy, or robotic-assisted myomectomy.
• Open Surgery: A larger incision is made in the abdomen to access the uterus. This method is used when dealing with larger fibroids or when multiple fibroids need to be removed.
• Laparoscopic Myomectomy: Several small incisions are made in the abdomen. A laparoscope (a thin tube with a camera and light) is inserted to visualize the uterus. Surgical instruments are then inserted through the other incisions to remove the fibroids.
• Robotic-Assisted Myomectomy: Similar to laparoscopic myomectomy, but with the added precision of a robotic system to control the surgical instruments.
• Fibroid Removal: The surgeon carefully identifies and removes the fibroids from the uterus. The removal technique depends on the size, number, and location of the fibroids.
• Uterine Repair: After the fibroids are removed, the surgeon repairs the uterine wall to promote healing and reduce the risk of complications. Sutures are used to close any incisions or areas where the fibroids were removed.
• Closure: In open surgery, the incision is closed with sutures or staples. In minimally invasive methods, the small incisions are closed with sutures.
• Recovery: After the procedure, the patient is taken to a recovery area where they are monitored as they wake up from anesthesia. The time spent in recovery depends on the procedure type and the patient's condition.
• Post-Operative Care: The patient will receive instructions on wound care, pain management, and activities to avoid during recovery.

Indications of Fibroid Removal

• Heavy Menstrual Bleeding: Fibroids can cause excessive and long-lasting menstrual bleeding (menorrhagia), leading to anemia and fatigue. If other treatments don't control the bleeding, fibroid removal may be needed.
• Pelvic Pain: Fibroids can cause pelvic pain, which can range from mild to severe. This pain may occur during menstruation or at other times, affecting daily activities.
• Pressure and Pain on Pelvic Organs: Large fibroids can put pressure on nearby organs like the bladder or rectum. This can cause symptoms such as frequent urination, constipation, or pain during intercourse.
• Infertility or Pregnancy Issues: Fibroids can interfere with fertility by affecting the uterus's ability to support a pregnancy. They can also lead to pregnancy complications like miscarriage or preterm labor.
• Rapid Fibroid Growth: If fibroids grow quickly or become large enough to cause pain or other issues, removal may be recommended.
• Failed Non-Surgical Treatments: If treatments like medication, hormonal therapy, or procedures to control bleeding don't provide relief, fibroid removal might be necessary.
• Desire to Keep Uterine Function: Women who want to preserve their ability to conceive and carry a pregnancy may choose fibroid removal over a hysterectomy (removal of the entire uterus).

How to Prepare for Fibroid Removal Surgery?

Preparing for fibroid removal, also known as myomectomy, involves multiple steps. Preparing for a successful procedure and smooth recovery involves multiple steps. Here is a guide:

• Consultation: Visit a gynecologist or surgeon to discuss your symptoms, medical history, and the best treatment plan for your fibroids.
• Medical Tests: Your doctor may recommend tests like ultrasounds or MRIs to gather more information about your condition.
• Medications: Inform your doctor about all the medications you're taking.
• Nutrition & Hydration: Eat a healthy diet and stay hydrated to support healing after surgery.
• Stop Smoking & Alcohol: Reduce or stop smoking and drinking to help with recovery.
• Stay Hydrated: Drink plenty of water leading up to the procedure.
• Transportation: Arrange for someone to drive you to and from the hospital, as you won't be able to drive after anesthesia.
• Follow Fasting Instructions: Follow your doctor's instructions on when to stop : eating and drinking before surgery.
• Pack Essentials: Bring comfortable clothing, underwear, and personal items for your stay.
• Arrive Early: Arrive on time to complete paperwork and meet the medical team.
• Understand the Procedure: Ask your doctor to explain the surgery, risks, and recovery.
• Arrange Support: Have someone stay with you for a few days after surgery to help with tasks and provide support.
• Mental Preparation: Prepare mentally to reduce anxiety before the procedure.
• Take Pre-Op Medications: Follow your doctor's instructions for any medications before surgery.

What Happens During the Fibroid Removal Procedure?

Here's a quick overview of what to expect during fibroid removal (myomectomy).

Before Surgery

• You'll have imaging (like ultrasound/MRI) to locate fibroids.
• You fast for a few hours.
• General anesthesia is usually given.

During Surgery (Depends on Type)

Abdominal (Open) Myomectomy

• Large cut in lower belly.
• Fibroids were removed from the uterus.
• Uterus and abdomen stitched up.

Laparoscopic Myomectomy

• Small cuts + camera.
• Fibroids are removed through tiny tools.
• Less invasive, quicker healing.

Hysteroscopic Myomectomy

• No cuts, scope goes through vagina.
• Fibroids inside the uterus were shaved off.
• Outpatient, very quick recovery.

After Surgery

• You wake up in recovery.
• Hospital stay: A few hours to 2-3 days (depends on type).
• Recovery time: Open: 4-6 weeks
• Laparoscopic: 2-4 weeks
• Hysteroscopic: A few days

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Who Performs the Fibroid Removal Procedure?

Fibroid removal procedures are usually performed by gynecologists, especially those who specialize in gynecologic surgery. Here are the types of medical professionals who may be involved in your fibroid treatment and removal:

• Gynecologist
• Gynecologic Surgeon
• Reproductive Endocrinologist
• Interventional Radiologist
• Obstetrician-Gynecologist (Ob-Gyn)
• Minimally Invasive Surgeon
• Surgical Oncologist

Recovery After Fibroid Removal Procedure

• Immediate Post-Operative Care: After surgery, you'll be monitored in a recovery area as you wake up from anesthesia. Expect some pain or grogginess, and pain medications will be given as needed.
• Hospital Stay or Discharge: Depending on the surgery type and your health, you might go home the same day or stay overnight. You'll receive instructions on wound care, medications, and activity limits.
• Pain Management: Pain is common after surgery, and your doctor will prescribe pain relief. Follow the medication plan carefully.
• Rest and Activity: Rest is essential early in recovery. Avoid heavy lifting and strenuous activities, but gradually increase your activity level as advised by your doctor.
• Incision Care: Keep your incision clean and dry. Watch for signs of infection, like redness or swelling, and contact your doctor if you notice anything unusual.
• Return to Work and Activities: You can usually return to desk jobs in a couple of weeks, but more physically demanding jobs may require more time off. Follow your doctor's advice for resuming normal activities.
• Follow-Up Appointments: Attend all follow-up appointments to monitor your healing and address any concerns.
• Exercise and Sexual Activity: Check with your doctor before resuming exercise, sexual activity, or other strenuous activities.
• Recovery Time: Full recovery can take a few weeks to a few months, depending on the surgery type. Be patient and allow your body time to heal.
• Post-Operative Symptoms: Mild bloating or spotting is normal. Contact your doctor if you experience severe pain, heavy bleeding, or other concerning symptoms.
• Emotional Well-being: Recovery can bring emotional ups and downs. Lean on friends and family for support, and focus on self-care during this time.

Lifestyle Changes for A Smooth Recovery After Fibroid Removal

• Prioritize Rest: Get enough rest and sleep to help your body heal and reduce complications.
• Follow Post-Operative Instructions: Stick to the instructions provided by your doctor for wound care, medications, and activity limits.
• Nutrition: Eat a balanced diet with plenty of fruits, vegetables, lean proteins, whole grains, and healthy fats to support healing and boost your immune system.
• Stay Hydrated: Drink at least eight glasses of water a day to stay hydrated and aid in recovery.
• Light Physical Activity: Start with gentle walking to improve circulation. Check with your doctor before returning to more intense exercise.
• Avoid Heavy Lifting: Refrain from lifting heavy objects and doing strenuous activities while you heal to avoid putting strain on your incision sites.
• Gradual Return to Normal Activities: Slowly ease back into daily tasks, starting with light chores and gradually progressing to more demanding activities.
• Manage Stress: Use stress-reduction techniques like deep breathing or meditation to help with emotional and physical recovery.
• Avoid Smoking and Alcohol: Minimize or eliminate smoking and alcohol, as they can slow healing and increase complications.
• Regular Follow-Up Appointments: Attend all follow-up visits with your doctor to track your recovery and address any concerns.
• Emotional Well-Being: Understand that emotional changes are normal during recovery. Seek support from family, friends, or groups if needed.
• Compression Garments: If recommended, wear compression garments to improve circulation and reduce the risk of blood clots.
• Hygiene and Wound Care: Keep your incision clean and dry, following your doctor's instructions. Contact your doctor if you notice any signs of infection.
• Listen to Your Body: Pay attention to your body's signals. If you experience pain or unusual symptoms, reach out to your healthcare provider.