What is laparoscopic myomectomy?

Laparoscopic Myomectomy
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Laparoscopic myomectomy: Overview

A myomectomy is surgery to take out fibroids. The uterus is left in place. Uterine fibroids are tumors that grow in the wall or muscle of the uterus. They are not cancer.

Before surgery, you will get medicine to make you sleep.

Laparoscopic surgery is done with only small cuts. These cuts are called incisions. The doctor puts a lighted tube, or scope, and other tools through the cuts in your belly. The doctor is able to see your organs with the scope. The doctor removes the fibroids. The cuts heal quickly, and the scars usually fade over time.

Most people go home on the day of the surgery. After surgery, you will probably have some pain for several days.

This surgery should reduce the pain and heavy bleeding you've had from fibroids. If you've had trouble getting pregnant, this surgery may help after several months of healing. Your doctor may talk to you about when you can have sex and when it's safe to try to get pregnant.

How can you care for yourself after laparoscopic myomectomy?

Activity

  • Rest when you feel tired.
  • Be active. Walking is a good choice.
  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better.
  • Ask your doctor when it is okay for you to have sex or use tampons. Do not douche.
  • Hold a pillow over your incisions when you cough or take deep breaths. This will support your belly and may help to decrease your pain.
  • Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.

Incision care

  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
  • If you have skin adhesive on the incision, leave it on until it falls off. Skin adhesive is also called liquid stitches.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
  • Change the bandage every day.
  • Keep the area clean and dry.

Other instructions

  • Talk to your doctor if you want to try to get pregnant soon. Your doctor can tell you when it's safe to do so. If you don't want to get pregnant, talk with your doctor about birth control.
  • Wear loose, comfortable clothing. For a few weeks, avoid anything that puts pressure on your belly.
  • You may have some light vaginal bleeding. Wear sanitary pads if needed.
  • You may want to use a heating pad on your belly to help with pain.

How do you prepare for a laparoscopic myomectomy?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After laparoscopic myomectomy: Overview

Laparoscopic myomectomy is surgery to remove one or more fibroids. Your doctor put a lighted tube (scope) and other tools through small cuts (incisions) in your belly. The doctor then removed the fibroids.

After surgery, you may feel some pain in your belly for several days. Your belly may also be swollen. You may have a change in your bowel movements for a few days. And you may have some cramping for the first week.

It's normal to also have some shoulder or back pain. This is caused by the gas your doctor put in your belly to help see your organs better.

Your doctor may prescribe medicines for pain. You may need about 1 to 2 weeks to fully recover. It's important not to lift anything heavy for about 1 week. Your doctor may talk to you about when you can have sex and when it's safe to try to become pregnant.

You may have a brown or reddish brown vaginal discharge or light vaginal bleeding or spotting for a few weeks. This is normal. Expect your first two periods to start early or late. They may be more painful or heavy than usual.

What happens on the day of your laparoscopic myomectomy?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • This surgery can take 15 minutes for a small, simple fibroid to a few hours for multiple large fibroids. Ask your surgeon how long your surgery is likely to take.

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