Can a 9cm Uterine Fibroid Be Removed via Laparoscopy?

Uterine fibroids

Dear Doctor: Is it possible to remove a uterine fibroid measuring approximately 9 centimeters using laparoscopic surgery? Does Hsinchu Hospital have a department that performs this type of surgery? Thank you.

Lin, 30~39 year old female. Ask Date: 2010/07/11

Dr. Li Guanghan reply Obstetrics and Gynecology

Do uterine fibroids require surgery? If surgery is necessary, should only the fibroids be removed or is a total hysterectomy needed? Will the procedure be performed through open surgery or laparoscopic surgery? Will it be done through the abdomen or the vagina? These questions cannot be determined solely based on the size of the uterine fibroids.
It is recommended that you discuss these questions in detail with your attending physician.
Wishing you peace and good health.

Reply Date: 2010/07/11

More Info

Laparoscopic surgery, also known as minimally invasive surgery, is a common approach for the removal of uterine fibroids, including those that are relatively large. A 9 cm uterine fibroid can potentially be removed via laparoscopy, but several factors must be considered to determine the feasibility and safety of the procedure.

Firstly, the size of the fibroid is a significant factor. While laparoscopic myomectomy (the surgical removal of fibroids) is typically performed for fibroids that are smaller than 5-6 cm, larger fibroids can still be removed laparoscopically, especially if the surgeon is experienced and the fibroid is not causing significant complications. In some cases, larger fibroids may require a technique called morcellation, where the fibroid is broken into smaller pieces to facilitate removal through the small incisions used in laparoscopic surgery.

Secondly, the location of the fibroid plays a crucial role. Fibroids can be classified based on their position within the uterus: subserosal (on the outer wall), intramural (within the uterine wall), or submucosal (protruding into the uterine cavity). Subserosal fibroids are generally easier to remove laparoscopically compared to intramural or submucosal fibroids, which may require more complex surgical techniques.

Additionally, the overall health of the patient and any underlying conditions must be taken into account. Factors such as the presence of adhesions from previous surgeries, the patient's body mass index (BMI), and any other medical conditions can affect the surgical approach and outcomes. A thorough preoperative evaluation, including imaging studies like ultrasound or MRI, will help the surgeon assess the fibroid's characteristics and plan the best approach.

It is also important to discuss the potential risks and benefits of laparoscopic myomectomy with your healthcare provider. While laparoscopic surgery generally offers advantages such as reduced recovery time, less postoperative pain, and minimal scarring compared to open surgery, there are still risks involved, including bleeding, infection, and the possibility of needing to convert to an open procedure if complications arise.

In conclusion, a 9 cm uterine fibroid can potentially be removed via laparoscopy, but it is essential to consult with a qualified gynecologist who specializes in minimally invasive surgery. They will evaluate your specific case, including the fibroid's size, location, and your overall health, to determine the most appropriate surgical approach. If the hospital you mentioned, Hsinchu Hospital, has a department that performs laparoscopic myomectomy, it would be beneficial to seek a consultation there to discuss your options further.

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