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Fibroid Surgery

What is Fibroid Surgery?

There is quite a bit of difference of opinion between gynecologists in the way they approach the treatment of patients with uterine fibroids. In most cases Viva Eve fibroid surgery NYC specialists recommend treatment only when fibroids cause symptoms, such as excessive menstrual bleeding, pain, abdominal distention, or urinary frequency.

Viva Eve’s team of fibroid surgery NYC experts believe in empowering women by educating them about all their treatment options. They will only recommend fibroid surgery if other less invasive treatments are not an option in your particular situation. If your NYC Fibroid Specialist at Viva recommends that you have fibroid surgery, you have two options: Hysterectomy and Myomectomy.

25 %
of women in the US who undergo a hysterectomy don’t need it.
40 %
of women are not offered alternative treatments prior to a hysterectomy.
600000
women undergo a hysterectomy (the surgical removal of the uterus and sometimes other reproductive organs) every year in the United States.

Hysterectomy

A hysterectomy is surgery to remove a woman’s uterus or womb. After a hysterectomy, women no longer have menstrual periods and can’t become pregnant. Sometimes this type of fibroid surgery also removes the ovaries and fallopian tubes. 

While fibroids and adenomyosis are one of the most common reasons for having a hysterectomy, other reasons may include endometriosis, chronic pelvic pain, cancer, and uterine prolapse. 

A hysterectomy can be done in different ways: through the vagina, through the abdomen, or with laparoscopy. The choice will depend on the reason for the surgery and other factors. Sometimes, the decision is made after the fibroid surgery begins and the surgeon can see whether there are other problems.

Hysterectomy is an established solution for symptomatic uterine fibroids and may be the best option for some women; however, it is a highly invasive fibroid surgery that results in the loss of their uterus.

Despite being one of the most common surgeries for women in the US, the procedure is often not well understood by patients and few patients know that many hysterectomies are performed unnecessarily and research other less invasive options.

Multiple studies have proven that seeking a second and third opinion from a fibroid specialist reduced the number of hysterectomies carried out to treat uterine fibroids.

Some Facts About Hysterectomy

  • In the US, hysterectomy is the second most performed surgery among women after cesarean section; around 1 in 3 will have the procedure by the age of 60. 
  • According to the CDC, up to 600,000 women undergo a hysterectomy (the surgical removal of the uterus and sometimes other reproductive organs) every year in the United States.
  • 1 in 5 women in the US who undergo the procedure don’t need it.
  • At least 50% of American women of reproductive age suffer from symptomatic uterine fibroids.
  • At least 30% of all hysterectomies in the United States are performed to treat uterine fibroids. 
  • Almost 40% of women were not offered alternative treatments prior to a hysterectomy.

What is Myomectomy?

A fibroid surgery that is most often suggested to women of childbearing age who would like to get pregnant in the future is a myomectomy.  This technique is used to remove fibroids while leaving the uterus intact and helps preserve or improve the woman’s fertility. 

Women who are offered a myomectomy as a treatment option by their NYC Ob/Gyn are often instructed to have an open myomectomy procedure. Open myomectomy is an effective fibroid removal procedure, but it requires larger incisions and can cause more complications and longer recovery times than newer, minimally invasive myomectomy surgery techniques.

The Viva Eve fibroid surgery NYC specialist will thoroughly evaluate your medical records and discuss an appropriate myomectomy technique available, including laparoscopic, robotic, and LAAM procedures (laparoscopically assisted abdominal myomectomy).

How do different myomectomy techniques compare?

TreatmentDescriptionWhat to Know About the ProcedureAdvantages & Disadvantages
Open MyomectomyDescription:
Also known as an abdominal myomectomy, involves removing the fibroids from the wall of the uterus. The uterine muscle is then sewn back together using several layers of stitches.
Anesthesia: General anesthesia required. 
Incisions: Incision through the skin on the lower abdomen, known as a “bikini cut,” should be large enough to remove the fibroid(s).
Length of procedure: 1–2 hours
Average Hospital Stay: 2-3 days
Effectiveness: Can remove uterine fibroids of almost any size, whether it is tiny or very large anywhere in the uterus.
Recovery: Fully recovered in 8-12 weeks.
Pros and Cons:
Pain and discomfort can last for 
7-10 days. Risks associated with major surgery, general anesthesia, and hospitalization. Fibroids can come back, especially in younger women. Effective in removing fibroids. You might need to wait six months for your uterus to fully heal depending on the exact type of surgery you have had before trying to get pregnant.
Laparoscopic/
Robotic Myomectomy
Description:
The surgeon performs this operation by inserting a laparoscope (a narrow lighted tube fitted with a camera) and surgical instruments into the small incisions in the abdominal wall.
If the surgery is being done robotically, the surgeon controls the instruments remotely using a robotic arm.
Anesthesia: General anesthesia required. 
Incisions: Several half inch incisions
Length of procedure: Up to 2 hrs (laparoscopic) up to 4 hours (robotic)
Average Hospital Stay: 1 – 2 days
Effectiveness: Can remove smaller uterine fibroids, the success of this procedure depends on the location of the fibroids. tiny or very large anywhere in the uterus.
Recovery: Fully recovered in about 4 weeks.
Pros and Cons:
Effective in removing certain types of fibroids, often chosen by women trying to get pregnant in the short term. You might need to wait six months for your uterus to fully heal depending on the exact type of surgery you have had before trying to get pregnant.

Not possible for larger fibroids. 
Faster recovery and much smaller scars than open myomectomy.
Hysteroscopic or Vaginal MyomectomyProcedure Description:
During the procedure a long, thin scope with a light is passed through the vagina and cervix into the uterus. The physician can look inside the uterus for fibroids and other problems, such as polyps. 
Submucous or intracavitary myomas are easily visualized and can be resected or removed using a wire loop or similar device. The same procedure is used for hysteroscopic polypectomies.
Anesthesia: General anesthesia required. 
Incisions: No incisions
Length of procedure: up to 2 hrs 
Average Hospital Stay: Most patients are able to go home after a few hours of rest at their doctor’s office. 
Effectiveness: Can remove smaller submucous or intracavitary uterine fibroids and significantly reduce bleeding and anemia.
Recovery: Patients can resume their normal work and exercise schedule within a couple of days.
Pros and Cons:
Because the procedure doesn’t involve incisions, there is reduced scarring and post-operative discomfort. 
Generally only fibroids that are small and accessible through the cavity can be treated this way.
You might need to wait three to six months for your uterus to fully heal depending on the exact type of surgery you have had before trying to get pregnant.
Laparoscopically Assisted Abdominal Myomectomy (LAAM)Procedure Description:
One of the most advanced minimally invasive surgical procedures Viva Eve offers. LAAM uses the best elements of both laparoscopic and open approaches to myomectomy.
Anesthesia: General anesthesia required. 
Incisions: 2 incisions: 1.5 to 2 inches at the bikini line; 0.5 inch incision at the belly button. Sometimes 1 or 2 additional incisions are needed
Length of procedure: 1–2 hours
Effectiveness: can remove uterine fibroids of almost any size, whether it is tiny or very large anywhere in the uterus.
Recovery: same day or overnight hospital stay. Fully recovered in 4-8 weeks.
Pros & Cons:
Surgical. LAAM procedure patients experience less pain and fewer complications. 
You might need to wait six months for your uterus to fully heal depending on the exact type of surgery you have had before trying to get pregnant.

Most hysterectomies and myomectomies are not emergencies. You have time to think about what you want to do and investigate whether these major surgeries are the only possible treatment options.

An increasing number of reproductive-age women with symptomatic uterine fibroids or a similar condition called adenomyosis are opting for less invasive procedures, like uterine fibroid embolization (UFE) or a myomectomy.

Viva Eve fibroid surgery specialists urge their patient to never hesitate to discuss alternatives to myomectomy and, especially, hysterectomy. Don’t give up until you are comfortable with what you hear. 

At Viva Eve we believe that a patient-physician relationship is a partnership. We will work with you until we find a treatment option for your symptomatic uterine fibroids or adenomyosis and together choose a treatment option that works for you and your unique circumstances. You and your doctor should both be satisfied with your treatment plan.

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