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da Vinci ® Robotic Myomectomy at Our Los Angeles Center

Robotic myomectomy is the technical term for the removal of uterine fibroids using the most modern surgical equipment such as the state-of-the-art da Vinci Surgical System at our Los Angeles surgery center. Approximately 65,000 patients undergo fibroid removal surgery each year. However, many women who experience unpleasant symptoms from these non-cancerous uterine tumors are reluctant to have conventional surgery due to the invasive nature of the procedure and the potential for a prolonged and uncomfortable recovery. Women who want to avoid the aftermath of myomectomy surgery may delay treatment for many years and just cope with their symptoms using over-the-counter medications and at-home therapies. They may believe that “the cure is worse than the disease.” Their fibroids can continue to grow over time and symptoms worsen. When women finally do undergo surgery, more tissue may have to be removed to get rid of these growths.

Who Is a Candidate for Robotic Myomectomy Surgery?

Women who have fibroids that are interfering with their quality of life may be candidates for this procedure. These growths can occur along the interior lining of the uterus, within the wall of the uterus itself, or on the exterior surface of the uterus. Depending on where the fibroids grow, their size and what other structures they press against, they may cause a range of unpleasant symptoms including:

  • Heavy menstrual bleeding and periods that last a week or longer (leading to anemia)
  • Severe cramping
  • Pain in the pelvis or a sense of fullness/pressure in the belly
  • Frequent need to urinate as well as difficulty totally emptying the bladder
  • Constipation from pressure on the rectum
  • Back pain or leg pains from pressure on the nerves
  • Pain during sexual intercourse

 

There are also patients who can benefit from this surgery even if they previously had no symptoms from their fibroids. Some women discover that they have uterine fibroids during an ultrasound evaluation designed to discover the underlying cause of infertility. These patients may be particularly interested in the uterus-sparing nature of the revolutionary da Vinci myomectomy. Fibroids inside the uterus are a known contributor to certain types of infertility. If they can be removed without causing too much trauma to the uterus, fertility is sometimes restored. Since miscarriage and early labor can also be associated with uterine growths, this surgery may also be recommended for patients who have experienced these problems in the past and wish to avoid them in future pregnancies.

What Did Fibroid Surgery Entail Before Robotic Myomectomy?

Up until recently, women were faced with a number of less-than-optimal choices for dealing with fibroid tumors. The most common solution offered was a straightforward hysterectomy. For women who are approaching menopause or done having kids, this may be an acceptable option. It is the only way to absolutely ensure the growths will not return. However, removal of the reproductive organs is still a pretty radical treatment considering the fact that fibroids are not cancerous. Just because a woman isn’t planning to “use” her uterus again doesn’t mean her only option should be having it removed.

The other surgical approach to fibroid treatment is the myomectomy. This procedure removes the fibroids and attempts to leave the uterus intact. The simplest way to provide a good view of the location and extent of fibroids is through an open abdominal incision. It gives the surgeon lots of room to maneuver and helps ensure that the tumors are removed with as little damage to the uterus as possible. That’s key for ensuring the uterus can still carry a pregnancy to term without rupturing (a life threatening complication for both mother and baby).

On the other hand, the open approach entails a lengthy and painful recovery. The large incision and the damage to tissues surrounding the uterus increase the risk of complications during healing as well. The only alternative to an open surgery prior to the introduction of robotic myomectomy was laparoscopic surgery. This is a much less invasive procedure than open myomectomy. However, it is not always practical depending on the size and location of the fibroids. In more than one out of four cases, what starts out as a laparoscopic myomectomy is switched to an open procedure once the surgeon sees the extent of the fibroids. This is a disappointing and challenging result for patients to deal with after the fact.

Benefits of Robotic Myomectomy

The da Vinci myomectomy is a state-of-the-art procedure that highlights all the ways that minimally invasive robotic surgery can offer a better solution than both open and laparoscopic procedures. It avoids the large incision of a traditional abdominal surgery with its higher risks of excessive bleeding, infection and scarring. Patients also avoid weeks and weeks of recovery time and can get back to their regular schedule of work and recreation much faster.

At the same time, the highly magnified operating field and the extreme precision of robotic surgical instruments in the hands of a skilled surgeon make the da Vinci approach preferable to laparoscopic surgery as well. Rather than being forced to operate with limited visibility and range of motion with laparoscopic equipment, the miVIP da Vinci surgeon has access and maneuverability similar to open surgery through incisions that are just the size of a dime.

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