Ioannis K. Raptis is an accredited physician (MIC II qualification) certified to perform advanced laparoscopic and hysteroscopic procedures of high complexity by the German Society for Gynecological Endoscopy (AGE). In cases where intra-abdominal tissue fragmentation is required, an innovative closed containment bag system is used to ensure patient safety in the event of malignancy (contained morcellation).
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Fibroids are benign tumors that develop within the wall of the uterus, mainly in women of reproductive age. These tumors usually grow gradually; however, in some cases, they may appear suddenly.
Fibroids are classified into three categories based on their location within the uterus: subserosal, intramural, and submucosal. Subserosal fibroids are those whose largest portion is located on the outer surface of the uterine wall. Those primarily found within the thickness of the uterine wall are called intramural fibroids. Finally, submucosal fibroids develop within the uterine cavity.
The discomfort and complications caused by fibroids depend on their size, number, and location within the uterus. The most common symptoms of fibroids are the following:
It is important to note that in rare cases, some fibroids may be malignant. This likelihood has been estimated at 1 in 300.
When removal of fibroids is required, laparoscopic myomectomy stands out as the safest and most effective treatment method.
The endoscopic, radical removal of fibroids without damaging healthy tissues not only relieves the woman from the symptoms of the condition but also restores the normal anatomy of the uterus without the risk of complications associated with conventional open surgery (bleeding, infection, wound-healing disorders, etc.). At the same time, the aesthetic outcome is excellent, as the incisions made to allow the surgeon access to the abdomen are microscopic.
Finally, laparoscopy offers significant advantages during the postoperative period, as pain is minimal, mobilization is immediate, and recovery time does not exceed 24 hours.
For the successful performance of laparoscopic removal of fibroids, patients are required to undergo an ultrasound and, in certain cases, an MRI scan. The results of these examinations are crucial, as they allow the surgeon to determine the exact location of the tumors to be removed. At the same time, the likelihood of a fibroid being malignant is evaluated.
Laparoscopy is a minimally invasive procedure, especially when compared to open abdominal surgery. This explains why recovery after laparoscopy is fast and virtually painless. The pain experienced by the patient upon awakening is minimal, mobilization is immediate, and within just 24 hours she can return to her daily routine. In many cases, hospitalization at the clinic is not required.
Incision care is simple and includes disinfection with a special antiseptic twice daily. No special adhesive dressings are required, and the patient may shower normally.
Finally, activities involving intense physical exertion (gym workouts, manual labor, etc.) should be avoided for 2–3 days in order to prevent abdominal pain.
Fibroids may be located on the outer surface of the uterus (subserosal), within the uterine wall (intramural), or inside the endometrial cavity (submucosal).
Some common symptoms include heavy or prolonged menstrual bleeding, abdominal pain, frequent urination, as well as infertility.
Depending on their size and location, fibroids may affect a woman’s ability to conceive or cause complications during pregnancy.
Although rare, a fibroid may be malignant – the likelihood is estimated at 1 in 300–500 cases.
