Depending on the nature of your condition, your doctor will work with you to create a plan of action. If you elect to have surgery, please know that eight Lehigh Valley Health Network surgeons who specialize in minimally invasive surgical techniques for women’s urologic and gynecologic disorders have also earned COEMIG™ designation. The COEMIG program recognizes their experience in this surgical specialty, their ability to deliver safe and evidence-based care and their commitment to patient education.
Here are some common treatments for uterine fibroids:
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First there was traditional surgery, with large incisions and long hospital stays. Then came minimally invasive surgery, with a camera to guide the surgeon. Now, people in the Lehigh Valley can benefit from next-generation robotic surgery. Lehigh Valley Health Network offers robotic surgery with the da Vinci® S HD Surgical System.
Surgeons are using the da Vinci robot to perform prostate cancer surgeries, hysterectomies, removal of fibroids and repair of vaginal vault prolapse. The robot gives your surgeon the ability to perform complex and delicate surgery with unmatched precision. Yet the scarring is minimal, and most patients have less pain, less time in the hospital and a faster recovery than with traditional surgery.
Instead of a long incision, the surgeon makes incisions that are just 1 to 2 centimeters – less than an inch. The robot's arms, which hold the surgical instruments, and a camera are inserted through these tiny incisions.
The camera inside your body magnifies the picture 10 times and transmits the image in 3-D high definition, so your surgeon has an excellent view. The doctor holds controls that feel like surgical instruments. When the surgeon moves his hand even a tiny bit, the robot reacts, following the doctor's hand movements exactly.
The maneuverability, precise reactions of the robot and visual clarity make it possible for your surgeon to operate confidently, with no need for a large incision.
The tiny incisions cause less trauma to your body. That means less blood loss, less pain after surgery and less risk for infection. Because robotic surgery is not as hard on your body as traditional surgery, you may be able to go home sooner – sometimes even the next day – and you probably will recover faster.
Certain drugs oppose estrogen (such as progestin and Danazol) and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, sometimes also are used.
This type of drug often is effective for women who experience occasional pelvic pain or discomfort.
This approach lowers levels of estrogen and triggers a “medical menopause.” Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States.
Hysterectomy may be performed employing open surgery through a large incision or with minimally invasive surgery (laparoscopy). However, Lehigh Valley Health Network performs this procedure robotically using da Vinci® Single Site® Surgery, where the surgeon operates through a single small incision of less than 1 inch long. Essentially, this creates a virtually scarless procedure.
The da Vinci Single Site surgery approach offers these potential benefits compared to open surgery:
- Lower rate for major complications
- Low conversion rate (need to convert to open surgery)
- Less blood loss and fewer transfusions
- Lower wound infection rate
- Virtually scarless results
- Minimal pain
- Faster recovery time
- Shorter hospital stay (typically less than 24 hours)
- Quicker return to normal activities
Skilled surgeons offer robotic surgery with three da Vinci® Si HD Surgical Systems. The robot gives our surgeons the ability to perform complex and delicate surgery. Lehigh Valley Health Network has three robotic surgical systems; two at Lehigh Valley Hospital-Cedar Crest and one at Lehigh Valley Hospital-Muhlenberg.
Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.
Uterine fibroid embolization, or uterine artery embolization (UAE), is a newer minimally invasive technique that doesn’t involve a large abdominal incision. The arteries supplying blood to the fibroids are identified and then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.