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Uterine fibroids are benign neoplasms. The tumor process occurs in the inner layer of the uterus. Myoma itself has the appearance of a node, so it is also called a myoma node. Uterine fibroids do not have specific symptoms and do not make themselves felt for a long time. Therefore, if a woman begins to show various signs, then this may indicate that the tumor process develops from benign to malignant.
As a rule, the first signs of the development of fibroids are: bleeding not during the menstrual cycle; symptoms of anemia with minor bleeding; sharp causeless pain in the lower back and lower abdomen; paroxysmal pain during the menstrual cycle; violations of the functionality of organs that are near the uterus (constipation, diarrhea, problems with urination). The danger of such diseases lies in the fact that they do not make themselves felt for a long time, and the first signs appear when the situation is critical.
Very often, fibroid neoplasms are diagnosed at the next examination by a gynecologist, while the woman did not even suspect about them. This is the danger of myoma tumor process. If the situation is running, then treatment with medication no longer makes sense, only surgery will help here. Recently, fibroids have been removed by laparoscopy.
Indications and contraindications
Many of the patients did not even know that uterine fibroids can be removed using laparoscopy. This procedure is considered less traumatic compared to other surgical interventions.
Specialists prescribe laparoscopy to patients who have been diagnosed with: myoma nodes with rapid growth; the impossibility of conceiving a child due to the presence of a neoplasm; negative impact on the functionality of nearby organs. Doctors also prescribe this procedure to patients diagnosed with subserous myoma nodes.
The main indication for laparoscopy is a large number of myoma nodes, which significantly deform the uterus. It is not excluded the operation of patients with the development of anemia as a result of the growth of fibroids.
It is allowed to carry out laparoscopic treatment only if the nodes are not more than six centimeters in diameter. Otherwise, the operation is carried out a little differently. Before removal of a large myomatous node, it is necessary to embolize the uterine arteries. This will significantly reduce the volume of neoplasm. Only then do the operation.
Laparoscopy is prohibited for patients with:
- cardiac and vascular pathologies;
- diseases of the respiratory system;
- obesity;
- small body weight;
- adhesive diseases.
Laparoscopy is categorically not performed on patients who have impaired blood clotting and in the presence of a hernia of various localization. But at the same time, embolization of the uterine arteries can be performed in patients with similar diseases.
Pros and cons of laparoscopy
The advantages of this procedure include low trauma. Compared to other methods, doctors make no more than four punctures, which in the end will remain invisible. There is also no large outer seam. During the operation, nearby organs are not injured. After the operation, the woman recovers quickly, after four days she can leave the hospital and gradually return to everyday life.
In addition, after laparoscopy, adhesions are practically not formed, and there is almost no bleeding during the removal of the nodes.
A day after the operation, the patient can stand up freely. By the way, doctors after such a procedure make women move more and lie less. There is practically no pain syndrome, so doctors do not prescribe painkillers.
Of course, there are many pluses, but there are also negative points. It is very important to seek the help of a qualified specialist, especially for women of childbearing age. Due to the lack of experience and skills, a large scar may remain after the operation, which significantly reduces the chances of naturally conceiving a child.
It is also worth noting the moment that after any operation on the genital organs, the conception of a child is possible only after 12 months. Otherwise, serious complications may begin. In order to prevent accidental conception during this period, you need to consult a doctor who can choose an effective method of contraception for you.
There is an opinion that after laparoscopy you do not need to wait a year and you can deal with the issue of conception, but remember that in this case the situation is individual. Therefore, it is better to consult with your doctor.
How is laparoscopy performed?
Laparoscopy can have three types of surgery: removal of the myomatous node while preserving the reproductive organ; removal of the node along with the uterus; removal of the neoplasm along with the uterus and its neck.
The choice of operation depends on the situation, namely, on the age of the patient, the size of the neoplasm, the condition of the uterine cervix and its internal mucosa.
So, the operation begins with the fact that the doctor makes three or four incisions (approximately one centimeter) and through them introduces a special tool that is directly involved in the operation. This instrument is called an endoscope, it is presented in the form of a telescopic tube, at the end of which there is a video system. Everything that the endoscope shoots is visualized on the screen.
During the operation, the abdominal cavity is filled with carbon dioxide, which greatly facilitates its implementation. Immediately before the operation, the patient is given anesthesia, which can be intravenous or inhalation. Everything depends on the situation.
Removal of fibroids lasts an average of 25 minutes, but may be delayed (if the case is severe enough).
How to prepare for the operation?
If the operation is planned, then before starting it is necessary to pass the appropriate tests, namely, all types of blood tests, urinalysis, ultrasound examination of the genital organs, vaginal smear, chest x-ray, electrocardiogram.
There must also be permission to conduct anesthesia, which is given by the therapist.
Before the operation, you need to talk with the anesthesiologist to exclude the possible development of an allergic reaction after anesthesia.
For 48 hours before the operation, you need to refrain from heavy food, carbonated drinks and alcohol. Before the laparoscopy itself, the woman’s intestines are washed.
If doctors have found a risk of blood clots, then the patient should bandage her legs with an elastic bandage.
The period of recovery
As a rule, a woman is discharged from the hospital three days after the operation, but there are exceptions (if the case was severe or something went wrong during the operation). It is very important to walk to activate blood circulation. Doctors force patients to move the very next day.
Today, laparoscopy occupies one of the first places among the operations for the removal of myomatous neoplasms. The main difference is minimal trauma, a quick recovery period, and the absence of acute pain. After surgery, women practically do not have stitches and other external defects.
It is also very rare that serious complications begin after laparoscopy.
Remember that fibroids in the early stages of development are asymptomatic, but over time it can develop into a malignant tumor. Therefore, it is worth undergoing preventive examinations by a gynecologist at least once a year.