Virginian-Pilot examines uterine fibroid removal procedures

Aug 24 2006

The Virginian-Pilot on Monday examined the different surgeries that can remove uterine fibroids.

According to the Mayo Clinic College of Medicine, uterine fibroids are benign growths that occur in about 75% of women.

The majority of women are not affected by fibroids, but some women experience pain or other complications, such as impaired fertility, the Pilot reports.

There are various procedures to remove the fibroids, including a surgery called embolization that blocks the blood supply to the growths, according to Silvina Bocca, an assistant professor of gynecology and obstetrics at Eastern Virginia Medical School's Jones Institute for Reproductive Medicine.

Some women choose embolization because it is minimally invasive, but it carries a high risk of infertility, according to Bocca.

The other surgical procedure, which often is done to preserve a woman's fertility, is known as myomectomy and is performed by surgically opening the abdomen.

The procedure is thorough but can cause scarring and infertility and involves a six-week recovery period.

A less invasive form of myomectomy is performed through small incisions in the uterus.

However, after the procedure the uterus cannot carry a fetus to term, according to Bocca.

In addition, a team of physicians has developed a robot-assisted myomectomy procedure called the da Vinci Surgical System, which performs a procedure that is similar to the traditional myomectomy but is minimally invasive, according to Arnold Advincula, an associate professor of gynecology at the University of Michigan Medical School.

The procedure, which was developed about five years ago and approved by FDA in April 2005 for general gynecological and obstetric use, uses a robot to make small incisions in the uterus.

Bocca said the robot's arms are flexible and are directed by the surgeon using joystick-like controls, adding that while using the robot, "[y]ou can see very small blood vessels and nerves that you can spare" during the procedure.

Women who undergo the robot-assisted outpatient procedure can return to work in about one week, according to Bocca.

She also said that she would like more women to undergo the procedure but that its availability will depend on increased insurance coverage (Young, Virginian-Pilot, 8/21).