More than 99 percent of fibroid tumors of the uterus are benign, and most require no treatment. However, if these growths get very large, they can become uncomfortable, enlarge the abdomen and bring on loner, heavier menstrual periods. Even some tiny fibroids can cause abnormal bleeding. Until recently, a woman with troublesome fibroids almost always ended up with a hysterectomy.
Herbert A. Goldfarb, MD
Hysterectomy is no longer the only treatment for uterine fibroids. Now, GnRH agonists and laparoscopic coagulation with lasers and bipolar needles are treatment options.
Laparoscopic myomectomy (LM) is a minimally invasive surgical procedure for the removal of uterine myomas. It was first described in the late 1970s by Semm. Subsequently, equipment has been developed to enhance the procedure. LM requires advanced laparoscopic skill and expertise in suturing and tissue removal. Laparoscopic assisted myomectomy (LAM), a procedure that combines operative laparoscopy and minilaparotomy, was described by Nezhat et al in 1994.
Approximately 750,000 hysterectomies are performed annually in the United States, with a mortality rate of about 12 per 10,000 operations.1 Costs to consumers and insurers have been estimated at approximately $1.7 billion per year.2 Thus, alternative procedures that are safer and less invasive, preserve the uterus, and cost less are increasingly in demand. In recent years, several such techniques have been introduced.