Uterine fibroids are non-cancerous growths that develop on or around uterine tissue. Fibroids can form inside or outside the uterus, or be embedded in the uterine walls. A woman can have one fibroid or more, which may remain unchanged, grow slowly or suddenly have rapid growth.

When fibroids remain small and do not cause symptoms, they can be left untreated. However the following conditions may indicate the need to treat fibroids:

  • Heavy and/or painful periods that result in anemia and disrupt a woman’s normal activities.
  • Bleeding between periods
  • Rapid growth of the fibroid(s)
  • Pelvic pain
  • Fertility problems

When fibroids must be removed, Virginia Mason specializes in using minimally invasive, uterine-sparing surgical methods. Virginia Mason gynecologic surgeons are skilled in performing robotic-assisted myomectomies using the da Vinci™ Surgical System. Da Vinci enables the surgeon to operate while controlling tools that bend and rotate with the dexterity of the human hand. A 3-D, high-definition view of the operative site guides the surgery, helping ensure precise removal with reduced risk of scarring and other complications.

The location of fibroids determines the surgical approach needed, and whether robotic-assisted surgery is performed. Types of myomectomy include:

  • Hysteroscopic Myomectomy. The hysteroscope is a slender device used to see inside the uterus for treating fibroids inside the uterine cavity. It is inserted through the vagina and cervix without needing a surgical incision. Tools used with the hysteroscope can shave away fibroid tissue, or use electricity or lasers to destroy fibroids. Hysteroscopy is typically performed as an outpatient procedure.
     
  • Laparoscopic Myomectomy. In cases where fibroids are attached to the outside of the uterus, a series of small incisions are made to view the fibroids with the laparoscope (a thin, light-transmitting instrument). Additional tools are then guided through the other incisions to remove the fibroids. When there are many fibroids, or they are large, robotic-assisted laparoscopy may help ensure an effective surgery and avoid a more invasive procedure.
     
  • Abdominal Myomectomy. In some cases myomectomy requires an abdominal incision to access the uterus. Abdominal myomectomy is performed under general anesthesia, and may be necessary due to the size of the uterus, position of the fibroid or other factors. 

How Effective is Myomectomy?

After myomectomy surgery, the majority of women get relief from the symptoms that prompted treatment, including excessive menstrual bleeding and pelvic pain. However, one myomectomy surgery is not considered a permanent treatment for fibroids. Women sometimes develop new fibroids that may or may not require treatment.

If you have questions about myomectomy or would like more information about this service, call (206) 223-6191.