Alternatives to Hysterectomy: Laparoscopic Myomectomy

Laparoscopic Myomectomy is one of the surgical treatments we can perform at Midwest Fertility Center to preserve the uterus and restore fertility in many cases. In May 2009, Dr. Carlos Rotman was awarded the First Prize by the American College of Obstetricians and Gynecologists for his Alternatives to Hysterectomy - Laparoscopic Myomectomy technique, a minimally invasive surgical procedure in which benign (non-cancerous) tumors are removed from the woman’s uterus, which is then reconstructed.

If you have been advised to undergo hysterectomy but still want to have children, please contact the staff at Midwest Fertility Center to schedule a consultation with Dr. Carlos Rotman.

• Uterine Fibroids
• Laparoscopic Myomectomy
• Laparoscopic Hysterectomy

Uterine Fibroids

Every year, more than 600,000 women in the United States undergo hysterectomy, a surgical procedure to remove the uterus. Around 80% of these hysterectomies are performed due to benign (non-cancerous) conditions. Half are due to the presence of benign tumors known as uterine fibroids.

The presence of uterine fibroids is a very common condition that can result in abdominal pain, vaginal bleeding, bloating, and in certain cases decreased fertility.

These "tumors" are generally not cancerous (the incidence of cancer is less than 1%) and are very common in women over the age of 35; however, they are also seen quite often in younger women, especially in those with a family history of this condition.

Although the majority of uterine fibroids could be safely removed while preserving the uterus, this condition still accounts for a large portion of cases where hysterectomy (removal of the uterus) is routinely performed.

Since we are talking about several hundred thousand cases per year in the United States alone, the magnitude of the impact of conservative laparoscopic management over hysterectomy in these patients would be considerable, to say the least.

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Alternatives to Hysterectomy - Laparoscopic Myomectomy

Many hysterectomies are still performed because Laparoscopic Myomectomy is an advanced technique that requires a significant amount of training and skill, as well as expensive specialized equipment, so fewer physicians are available to perform the procedure.

Fortunately, over the last 25 years, laparoscopic surgeons have been gaining more and more experience in the treatment of uterine fibroids with alternatives to hysterectomy.

Dr. Rotman and his team have been researching, reporting, and teaching Laparoscopic Myomectomy since 1982, and have never stopped refining their technique. Their expertise in this field allows many women to conserve their uteruses, even in cases where they have been told that hysterectomy was their only option.

Utilizing video laparoscopy with specially designed instruments, combined with very precise absorbable intra-uterine suturing, and complemented by their SLAM technique, which allows the removal of large quantities of tissue quickly and without problems, in the great majority of cases they are able to avoid hysterectomy and allow the patient to preserve her uterus.

Many of the earlier concerns regarding improper healing, uterine rupture during pregnancy or delivery, and excessive adhesion formation have proven unfounded.

Also, the small possibility of new tumors and/or residual growth should not discourage the use of Laparoscopic Myomectomy, nor justify hysterectomy as the primary approach.

Utilizing careful dissection, meticulous hemostasis, and proper suturing techniques, most patients would benefit from the procedure, irrespective of the size, number, and location of the tumors.

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Laparoscopic Hysterectomy

Some hysterectomies are still needed, but in cases where the uterus must be removed due to such situations as cancerous and precancerous conditions, the majority of patients could have the operation performed laparoscopically on an outpatient basis – without a large abdominal incision and without an overnight hospital stay.

A true laparoscopic hysterectomy, where the operation is performed completely by laparoscopy, is no small feat. It requires extensive training and years of experience on the part of the operating surgeons and operating room personnel.

Dr. Rotman’s team has been performing, improving, and teaching this technique around the world since 1989. In fact, they were among the first to perform laparoscopic hysterectomy in an outpatient setting.

We recommend that any woman who has been advised to undergo hysterectomy for fibroids consider a second opinion, including a thorough physical examination and review of her medical records, from a certified laparoscopic surgeon experienced in Laparoscopic Myomectomy.

For more information about Alternatives to Hysterectomy - Laparoscopic Myomectomy, or to schedule a Laparoscopic Myomectomy consultation with Dr. Carlos Rotman, please contact Midwest Fertility Center today.

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