Myoma surgery can be performed either closed or open.
How is closed myoma surgery performed?
In closed myoma surgery, the patient is completely put to sleep, general anesthesia is given. By entering through the navel with the camera, the uterus and ovaries are seen. 2-3 holes are drilled on both sides of the abdomen, close to the groin area, and surgical devices are inserted through these holes. The myoma is removed in the abdomen, then shrunk with a laparoscopic instrument, made to pass through the holes and removed through the holes in the lower abdomen. To remove myoma , the abdomen is not cut so that the patient does not have an abdominal incision.
Closed myoma surgery is suitable for fibroids embedded in the uterus or grown outside the uterus into the abdominal cavity. The fibroids located in the inner lining of the uterus towards the inside of the uterus are taken with a light camera system called hysteroscopy. During hysteroscopy , if more than 50% of the fibroid is visible, it can be removed from underneath, but less than 50% is visible, sometimes not removed if most of it is embedded in the uterine wall. In such cases, closed myoma surgery may not be applied, and open myoma surgery may be required.
People who have had closed uterine fibroid surgery state that the pain is less and they stand up immediately. The average length of stay in the hospital is one day.
How many hours does the closed myoma surgery take?
It takes 1.5 hours on average.
In which patients is closed myoma surgery performed?
Preoperative evaluation of patients is very important. With ultrasound and MR examination, the location of the myoma, its location in the uterus, and whether it is suitable for closed surgery are analyzed. It is very easy to remove fibroids that have grown outside of the uterus, and fibroids embedded in the uterus can also be removed. If the fibroid has advanced towards the inner lining of the uterus, into the space where the baby grows, it should be removed by hysteroscopy rather than laparoscopy.
I am closed fibroids In which patients the surgery cannot be performed?
Closed surgery is not recommended in case of uterine cancer.
What should be considered after closed myoma surgery?
Things to consider after closed myoma surgery, open abdominal It is the same as fibroid surgery. The patient may bleed, which can sometimes be as much as menstruation. There may be abdominal pain, in which case simple painkillers will suffice. Antibiotics should be continued regularly. There are no restrictions on eating and drinking. One day after the operation, the patient can take a bath. It is necessary for the surgical hole area to be closed in order to reduce the risk of infection. Sexual intercourse is not allowed for one month, this is to prevent infection and pain. It is necessary to inform the doctor in cases of increasing pain, fever, gas and difficulty in making a large toilet.
What are the complications after closed fibroid surgery?
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Vaginal bleeding or bleeding from surgical puncture sites
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Infection; It is rarely seen after closed surgeries, urinary tract infection or surgical suture infection may occur
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Fever may occur, it can be experienced in many patients
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Intestinal injury may be because it is close to the uterus, it is very rare
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The bladder injury may be because it is an organ close to the uterus, it is very rare.
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Conversion to laparotomy, that is, open surgery; may be in the case of unstoppable bleeding. Every closed surgery carries the situation of reversion to openness, albeit a little.
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Adhesion around the uterus and inside the abdomen can occur in any surgery, it is less in closed surgeries.
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Inability to pass gas is a complication involving the intestines, it is rare.
In closed myoma surgery, the hospital stay is short, sometimes it is done on an outpatient basis, sometimes it is necessary to stay overnight. The patient has very little postoperative pain, and the risk of infection is very low. They can return to normal life in 2-3 days. After the operation, control is absolutely necessary, it is usually necessary to meet within a week and 10 days. Structure with ultrasound In the examination performed, the result of the piece taken, that is, the result of the pathology, is also evaluated.
Closed myoma surgery and Pregnancy
After myoma surgery it is possible to get pregnant. There is no difference between closed or open surgery in terms of being able to get pregnant. The main issue is that the uterus has been cut.
Is normal delivery possible after closed myoma surgery?
● Pregnancy is not recommended for 6 months after closed myoma surgery, the uterus is expected to heal .
● If there is a problem in conceiving after the surgery, the uterus and tubes should be evaluated with HSG.
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