Fibroid removal through laparoscopic surgery, with the aid of endo bag morcellation, offers a safe and effective solution for women with symptomatic fibroids.
Fibroids, non-cancerous growths in the uterus, can cause a range of uncomfortable symptoms such as heavy bleeding, pain, and pressure. For some women, surgical intervention may be necessary to alleviate these symptoms and improve their quality of life. In recent years, laparoscopic surgery, also known as keyhole surgery, has become a preferred option for fibroid removal due to its minimally invasive nature. This article explores the advantages of laparoscopy over vaginal hysterectomy, as well as the challenges posed by large fibroids during laparoscopic removal and how the technique of endo-bag morcellation and laparoscopic surgery can address these issues effectively.
Advantages of Laparoscopic Surgery
Laparoscopic surgery offers several key advantages over traditional vaginal hysterectomy:
Less Intraoperative Bleeding
Laparoscopic procedures are known for their precision and use of small incisions, which can lead to reduced intraoperative bleeding compared to vaginal hysterectomy.
Lower Risk of Infection
The minimally invasive nature of laparoscopy and the smaller incisions contribute to a lower risk of infection during the postoperative period.
Less Postoperative Pain
Patients who undergo laparoscopic surgery generally experience less postoperative pain compared to those who undergo vaginal hysterectomy, which often involves more tissue trauma and pulling.
Faster Recovery
With smaller incisions and reduced tissue manipulation, laparoscopic surgery typically results in a quicker recovery time for patients.
Laparoscopic Vs Vaginal Hysterectomy
Laparoscopy offers several advantages over vaginal hysterectomy, making it a preferred approach for fibroid removal, especially when dealing with large fibroids or significant symptoms. One major advantage of laparoscopy is the ability to perform focused fibroid removal, which is not possible with the vaginal route. Vaginal hysterectomy for large fibroids can involve significant pulling and tissue manipulation through the vaginal route, leading to dragging pain for patients postoperatively. Such discomfort is minimized in laparoscopic surgery due to the use of smaller incisions and more precise surgical instruments.
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Morcellation Techniques: Power Morcellation
To overcome the challenge of removing large fibroids during laparoscopy, surgeons may employ morcellation techniques. Morcellation involves dividing the fibroid into smaller pieces, making it easier to remove through small incisions. The most common technique used is power morcellation, where a rotating blade is utilized to cut the fibroid into smaller fragments.
Endo Bag Morcellation for Enhanced Safety
To further mitigate the risk of spreading cancer cells during morcellation, surgeons may opt for endo bag morcellation. This technique involves the use of a disposable bag inserted into the abdomen through one of the incisions. The fibroid is then placed inside the bag and morcellated within the bag’s confines. Once morcellation is complete, the bag containing the smaller fibroid pieces is safely removed through the incision.
Endo bag morcellation offers several advantages:
- Reduced Risk of Cancer Cell Spread: By confining the morcellated tissue within the bag, the risk of spreading cancer cells, if present, is minimized.
- Prevention of Bacterial Spread: The use of the endo bag also helps prevent the spread of bacteria that may be released during the morcellation process.
Fibroid removal through laparoscopic surgery, with the aid of endo bag morcellation, offers a safe and effective solution for women with symptomatic fibroids. The technique enables the removal of large fibroids through small incisions, minimizing discomfort, intraoperative bleeding, and infection, and promoting a faster recovery. However, the choice of surgical approach should be made in consultation with a healthcare professional who can evaluate individual needs and provide personalized recommendations for the best treatment.
(The above article is written by Dr Usha BR, Consultant – OBGYN, Fertility & Laparoscopic Surgeon, Fortis Hospital, Bannerghatta Road, Bengaluru.)
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