Uterine Fibroids Associated With Infertility
Uterine Fibroids Associated With Infertility
Although a minimally invasive approach is often desirable, at times open myomectomy is necessary. If there are numerous complicating intra-abdominal adhesions, and/or the surgeon is not confident in his or her laparoscopic skills, then laparotomy should be performed. In these circumstances, however, the standard risks of open abdominal surgery apply, including the risk of increased blood loss and longer recovery time in comparison with minimally invasive approaches. The advent of laparoscopic morcellators has decreased the need for the open approach, as previously it was required for large myomas to be removed via laparotomy. However, very large myomas (i.e., >20 cm in diameter) or any that are suspected of being malignant still require an open approach.
Laparotomy
Although a minimally invasive approach is often desirable, at times open myomectomy is necessary. If there are numerous complicating intra-abdominal adhesions, and/or the surgeon is not confident in his or her laparoscopic skills, then laparotomy should be performed. In these circumstances, however, the standard risks of open abdominal surgery apply, including the risk of increased blood loss and longer recovery time in comparison with minimally invasive approaches. The advent of laparoscopic morcellators has decreased the need for the open approach, as previously it was required for large myomas to be removed via laparotomy. However, very large myomas (i.e., >20 cm in diameter) or any that are suspected of being malignant still require an open approach.
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