Top Myomectomy Surgery in Delhi

Indications

A myomectomy is indicated in the following situations:

• Symptomatic Fibroids: Fibroids causing significant symptoms such as heavy menstrual bleeding, pelvic pain, or pressure.
• Infertility: Fibroids suspected to be interfering with conception or pregnancy.
• Growth of Fibroids: Rapid growth of fibroids or significant increase in size.

Types of Myomectomy

1. Abdominal Myomectomy (Laparotomy)
   • Procedure: An open surgery involving an incision in the lower abdomen to access and remove fibroids.
   • Indications: Large or numerous fibroids, or those deeply embedded in the uterine wall.
2. Laparoscopic Myomectomy
   • Procedure: A minimally invasive surgery using small incisions and a laparoscope (a thin, lighted tube with a camera) to remove fibroids.
   • Indications: Smaller or fewer fibroids, located in accessible areas of the uterus.
3. Hysteroscopic Myomectomy
   • Procedure: A minimally invasive surgery using a hysteroscope (a thin, lighted tube inserted through the vagina and cervix) to remove fibroids from inside the uterine cavity.
   • Indications: Submucosal fibroids (fibroids growing into the uterine cavity).

Procedure Steps

1. Preoperative Preparation
   • Evaluation: Comprehensive medical evaluation, including pelvic examination, ultrasound, or MRI to determine the size, number, and location of fibroids.
   • Medical History: Assessment of the patient’s overall health, allergies, and any previous reactions to anesthesia.
   • Patient Education: Explanation of the procedure, risks, benefits, and expected outcomes.
2. Anesthesia
   • General anesthesia is typically administered to ensure the patient is comfortable and pain-free during the procedure.
3. Surgical Procedure
   • Abdominal Myomectomy:
     • Incision: A horizontal (bikini line) or vertical incision is made in the lower abdomen.
     • Fibroid Removal: The surgeon locates and removes the fibroids from the uterine wall.
     • Closure: The uterine muscle is repaired with sutures, and the abdominal incision is closed.
   • Laparoscopic Myomectomy:
     • Incisions: Several small incisions are made in the abdomen.
     • Laparoscope Insertion: A laparoscope and surgical instruments are inserted through the incisions.
     • Fibroid Removal: The surgeon locates and removes the fibroids, often using a morcellator to cut the fibroids into smaller pieces for removal.
     • Closure: The incisions are closed with sutures or surgical tape.
   • Hysteroscopic Myomectomy:
     • Hysteroscope Insertion: The hysteroscope is inserted through the vagina and cervix into the uterine cavity.
     • Fibroid Removal: The surgeon uses instruments passed through the hysteroscope to remove the fibroids.
     • Closure: No external incisions are required, and the cervix is left to heal naturally.
4. Postoperative Care
   • Pain Management: Pain relief medications are prescribed as needed to manage discomfort.
   • Wound Care: Instructions on how to care for the surgical site (if incisions were made), including keeping it clean and dry to prevent infection.
   • Activity Restrictions: Avoiding strenuous activities, heavy lifting, and sexual intercourse for a specified period to allow proper healing.
   • Follow-Up: Regular follow-up appointments to monitor healing progress, remove sutures (if needed), and assess for any complications or recurrence of fibroids.

Risks and Complications

• Infection: Risk of infection at the surgical site or within the uterus.
• Bleeding: Risk of significant bleeding during or after the procedure.
• Scar Tissue Formation: Development of adhesions or scar tissue that can affect future fertility or cause pelvic pain.
• Recurrence of Fibroids: Possibility of new fibroids developing in the future.
• Damage to Surrounding Organs: Risk of injury to the bladder, bowel, or blood vessels.
• Uterine Rupture: Rare but serious risk of uterine rupture during future pregnancies, especially after abdominal myomectomy.

Recovery and Outlook

• Immediate Recovery: Most patients can go home the same day or after an overnight stay, depending on the type of myomectomy performed. Mild discomfort, cramping, and light vaginal bleeding are common and usually resolve within a few weeks.
• Long-Term Outlook: Myomectomy is generally effective in alleviating symptoms caused by fibroids and improving fertility outcomes. Regular follow-up and monitoring are important to detect any recurrence of fibroids.
• Fertility Considerations: Many women can conceive and have successful pregnancies after myomectomy, but it is important to discuss future pregnancy plans with a healthcare provider to ensure proper management and care.

Conclusion

Myomectomy is a valuable surgical option for women seeking relief from symptoms caused by uterine fibroids while preserving their uterus and fertility. The choice of surgical technique depends on the size, number, and location of the fibroids, as well as the patient’s overall health and reproductive goals. Proper preoperative assessment, skilled surgical technique, and diligent postoperative care are essential for optimal outcomes. Close communication with healthcare providers and adherence to follow-up instructions are crucial for successful recovery and long-term management of fibroids.