Indications for laparoscopic myomectomy for uterine myoma
Laparoscopic Myomectomy - is sparing surgery for uterine cancer, which is endoscopic removal of nodes through punctures, cuts, made on the anterior abdominal wall.
The advantages of laparoscopic myomectomy
This intervention can save the menstrual function and fertility. Laparoscopic myomectomy is characterized by a low-traumatic, preserving the anatomy of the pelvic floor, and short periods of rehabilitation.
Its advantages are not as pronounced as in the abdominal access, less pain and blood loss.
Indications for laparoscopic myomectomy
The operation is performed when there are miscarriages and infertility (to the exclusion of their other reasons), a syndrome of pelvic pain due to disorders of blood circulation in myomatous nodes, and impaired function of adjacent organs with the uterus as a result of mechanical compression.
Indications for laparoscopic myomectomy are large (more than 7-10 cm), tumor size, fibroids in conjunction with other disorders, subperitoneal tumors and nodes on the stem, dictating the need for surgical treatment, the presence of Meno-and metrorrhagia, leading to anemia.
Contraindications to laparoscopic myomectomy
Contraindications to perform laparoscopic myomectomy is a suspicion of malignancy, multiple interstitial sites, which are not removed will maintain reproductive function. Another controversy is the question of the possibility of this type of intervention in the presence of pronounced adhesions and obesity II-III degree.
The procedure is not performed in cases where there are general contraindications to laparoscopy, implying the presence of pathology, which at the time of the planned intervention creates a danger to the life of the patient. Such diseases include severe hemorrhagic diathesis, decompensated processes in the organs of the cardiovascular and respiratory systems, hemophilia, acute and chronic liver failure, diabetes mellitus.
The technique of laparoscopic myomectomy
The surgery is performed under general anesthesia, duration of 30 minutes - 2 hours. During laparoscopic myomectomy is a trocar incision in the umbilicus for the introduction of a laparoscope into the abdominal cavity and 2-3 punctures in the abdomen for surgical tools used in the removal of fibroids.
Today during laparoscopic myomectomy is actively using the latest techniques: laser, ultrasonic and electrosurgical. Closure of wounds to produce quality suture and polymer materials. This speeds up the recovery process during and after the intervention improves the outcome.
Disadvantages of laparoscopic myomectomy
Among the disadvantages is the possibility of recurrence of fibroids because of the impossibility of tactile definition of small nodes during surgery and the need for highly skilled surgeon, due to the technical complexity of the method.
Complications of laparoscopic myomectomy
Among the complications of laparoscopic myomectomy include damage to internal organs (bladder, ureter, intestine) and the great vessels during the introduction of trocars, as well as bleeding from the uterus during or after surgery, hematoma with inadequate layered suturing the defects of the uterine wall, abdominal wall hernia after extraction through her makropreparatov, infectious complications.