Re: laparotomy (abdom myo) vs. laparoscopic myo

[Guest guest]

Which one did your doctor recommend?

> Can anyone give me a rundown of the pros and cons of doing a

>laparoscopic myo vs doing an abdominal myo (laparotomy)? I have an

>intramural fundal fibroid (10 cm spherical) and definitely want to

>maximize my chances of getting pregnant at some later date.

[Guest guest]

Which one did your doctor recommend?

> Can anyone give me a rundown of the pros and cons of doing a

>laparoscopic myo vs doing an abdominal myo (laparotomy)? I have an

>intramural fundal fibroid (10 cm spherical) and definitely want to

>maximize my chances of getting pregnant at some later date.

[Guest guest]

I am scheduled for an abdominal myo on Tuesday for my intramural

fibroid (also partial submucosal as it's pressing into my uterine

wall). I am doing the ab myo vs the lap myo for the very reason you

should -- I want to get pregnant again. My dr explained that he

needs to be extra careful removing the fibroid, and stitching

everything back up, so that he preserves my utereus for future

pregnancy. He could do it laproscopically, but wouldn't be assured

of maintaining the integrity of the utereus, he said. Lap myo's are

best for women not wanting more kids, but wanting to keep their

utereus.

Another reason you may want to consider an ab myo is that your

fibroid is pretty large -- mine is only 3x3x3, and dr. told me that

I would have been a good candidate for a lap myo, if it wasn't for

the fertility issue.

I've done a lot of research on this, and have read the same over and

over. Stick with the ab myo, and you'll have a longer recovery

period, but will have much better odds of a successful pregnancy.

Also, dr. said that after an ab myo, women should have a c-section.

I've already had two, so I was prepared for that already.

Good luck, and I'll let you know how my surgery goes. I go under

the knife on Tuesday, and will hopefully be home by Thursday, or

Friday at the latest, dr. said. I'll let you know.

Kim

> Can anyone give me a rundown of the pros and cons of doing a

>laparoscopic myo vs doing an abdominal myo (laparotomy)? I have an

>intramural fundal fibroid (10 cm spherical) and definitely want to

>maximize my chances of getting pregnant at some later date.

[Guest guest]

I am scheduled for an abdominal myo on Tuesday for my intramural

fibroid (also partial submucosal as it's pressing into my uterine

wall). I am doing the ab myo vs the lap myo for the very reason you

should -- I want to get pregnant again. My dr explained that he

needs to be extra careful removing the fibroid, and stitching

everything back up, so that he preserves my utereus for future

pregnancy. He could do it laproscopically, but wouldn't be assured

of maintaining the integrity of the utereus, he said. Lap myo's are

best for women not wanting more kids, but wanting to keep their

utereus.

Another reason you may want to consider an ab myo is that your

fibroid is pretty large -- mine is only 3x3x3, and dr. told me that

I would have been a good candidate for a lap myo, if it wasn't for

the fertility issue.

I've done a lot of research on this, and have read the same over and

over. Stick with the ab myo, and you'll have a longer recovery

period, but will have much better odds of a successful pregnancy.

Also, dr. said that after an ab myo, women should have a c-section.

I've already had two, so I was prepared for that already.

Good luck, and I'll let you know how my surgery goes. I go under

the knife on Tuesday, and will hopefully be home by Thursday, or

Friday at the latest, dr. said. I'll let you know.

Kim

> Can anyone give me a rundown of the pros and cons of doing a

>laparoscopic myo vs doing an abdominal myo (laparotomy)? I have an

>intramural fundal fibroid (10 cm spherical) and definitely want to

>maximize my chances of getting pregnant at some later date.

[Guest guest]

My understanding is that with laparoscopy, the recovery time is shorter, and of

course the incisions/ scars are tiny in comparison (less trauma to the abdominal

muscles, etc. The advantage of laparotomy is that the surgeon can see and

maneuver more easily. (S)he can see more of your uterus. If you will have

laparoscopy, make sure the surgeon is expert in this procedure. It is very

different from laparotomy. My surgeon started off doing laparoscopy (put the

camara in), but when he saw 1 of my fibroids he became worried. It looked

abnormal (thank goodness it was not), plus it was in a place where he could have

easily knicked my bladder trying to cut it out (yikes...). He switched to

laparotomy, which made it easier to get the fibroids out plus he was able to

carefully examine my abdomen for other abnormalities. Keep in mind that not all

fibroids can be removed via laparoscopy (depends on location and size). Hope

that helps...

annryu wrote:

>Can anyone give me a rundown of the pros and cons of doing a laparoscopic myo

>vs doing an abdominal myo (laparotomy)? I have an intramural fundal fibroid

>10 cm spherical) and definitely want to maximize my chances of getting

>pregnant at some later date.

[Guest guest]

My understanding is that with laparoscopy, the recovery time is shorter, and of

course the incisions/ scars are tiny in comparison (less trauma to the abdominal

muscles, etc. The advantage of laparotomy is that the surgeon can see and

maneuver more easily. (S)he can see more of your uterus. If you will have

laparoscopy, make sure the surgeon is expert in this procedure. It is very

different from laparotomy. My surgeon started off doing laparoscopy (put the

camara in), but when he saw 1 of my fibroids he became worried. It looked

abnormal (thank goodness it was not), plus it was in a place where he could have

easily knicked my bladder trying to cut it out (yikes...). He switched to

laparotomy, which made it easier to get the fibroids out plus he was able to

carefully examine my abdomen for other abnormalities. Keep in mind that not all

fibroids can be removed via laparoscopy (depends on location and size). Hope

that helps...

annryu wrote:

>Can anyone give me a rundown of the pros and cons of doing a laparoscopic myo

>vs doing an abdominal myo (laparotomy)? I have an intramural fundal fibroid

>10 cm spherical) and definitely want to maximize my chances of getting

>pregnant at some later date.

[Guest guest]

My understanding is that with laparoscopy, the recovery time is shorter, and of

course the incisions/ scars are tiny in comparison (less trauma to the abdominal

muscles, etc. The advantage of laparotomy is that the surgeon can see and

maneuver more easily. (S)he can see more of your uterus. If you will have

laparoscopy, make sure the surgeon is expert in this procedure. It is very

different from laparotomy. My surgeon started off doing laparoscopy (put the

camara in), but when he saw 1 of my fibroids he became worried. It looked

abnormal (thank goodness it was not), plus it was in a place where he could have

easily knicked my bladder trying to cut it out (yikes...). He switched to

laparotomy, which made it easier to get the fibroids out plus he was able to

carefully examine my abdomen for other abnormalities. Keep in mind that not all

fibroids can be removed via laparoscopy (depends on location and size). Hope

that helps...

annryu wrote:

>Can anyone give me a rundown of the pros and cons of doing a laparoscopic myo

>vs doing an abdominal myo (laparotomy)? I have an intramural fundal fibroid

>10 cm spherical) and definitely want to maximize my chances of getting

>pregnant at some later date.

[Guest guest]

Hi-

Thanks for your help. I have a couple of questions below:

> My dr explained that he

> needs to be extra careful removing the fibroid, and stitching

> everything back up, so that he preserves my utereus for future

> pregnancy. He could do it laproscopically, but wouldn't be assured

> of maintaining the integrity of the utereus, he said. Lap myo's are

> best for women not wanting more kids, but wanting to keep their

> utereus.

Did your doc say why laps have a higher chance of compromising the integrity of

the uterus?

> I've done a lot of research on this, and have read the same over and

> over.

Do you have any good recs for places to get more info about this?

> Good luck, and I'll let you know how my surgery goes. I go under

> the knife on Tuesday, and will hopefully be home by Thursday, or

> Friday at the latest, dr. said. I'll let you know.

Good luck!

-Ann

[Guest guest]

I have spoken to two docs about this and am trying to decide which to go with.

One (Dr. Sakamoto in Berkeley CA) is saying abd myo. I have a meeting with him

tomorrow to get his opinion about a lap--we hadn't really discussed it before.

The other, Dr. Nezhat in Palo Alto CA, is a reproductive endocrinologist who is

also a specialist in uterine laproscopic surgeries and he strongly suggests

going with a laparoscopic myo. He says that the only real limiting factor in

laporoscopic myo is the experience of the surgeon (and it's pretty clear that

he's one of the most experienced lap surgeons for reproductive system issues in

the country). From everything I understand about lap vs. abd myo, I tend to

agree with him. But clearly I'm not sure yet.

-Ann

> > Can anyone give me a rundown of the pros and cons of doing a

> >laparoscopic myo vs doing an abdominal myo (laparotomy)? I have an

> >intramural fundal fibroid (10 cm spherical) and definitely want to

> >maximize my chances of getting pregnant at some later date.

[Guest guest]

Hi Ann,

I had the same question a few months back about which would be better

for me. My circumstances are different from yours as I am 51 and have

already had children. But I thought I could possibly add a bit to the

advice you've gotten so far.

I spoke with several doctors who did the abdom myo and one well-known

doctor who does the lap. My fibroids are 7.5 and 3.5, by the way. The

doctor who does the lap said that he could do the lap but couldn't

guarantee being able to remove both fibroids (or any others that might

be present that we don't know about). He said the lap takes longer to

do and depending on how long it took to remove the larger fibroid, it

might not be possible to remove the other since he can only keep a

patient under so long. He then proceeded to strongly make a case for a

lap. hysterectomy, which I had no interest in.

I decided at this point to give up the idea of the lap. myo. I wasn't

going to go through all of that and then still have a fibroid left to

possibly grow in the next few years and become a problem requiring

another myo. The other reason I chose the abdom was because the doctor

is definitely much more able to see if there are any other problems

present and since I had a UAE done two years ago, I just feel better

knowing that he will be able to see the results of that.

Hope this helps. I would definitely ask the RE if he can guarantee

removing all the fibroids with a lap. myo. (I assume you have more than

one). Good luck.

R.

[Guest guest]

The reason for ab vs. lap myo, according to my doc: when he gets

into the uterine wall, he'll remove the fibroid in pieces, so as to

minimize the " crater " left behind from the fibroid. He'll then be

in there, and have a bird's eye view, so CAREFULLY stitch the crater

closed, so that it minimizes scar tissue, and doesn't leave any

weakness to my utereus, for future pregnancies. He does a lot of

lap myo's, and actually prefers them (they're more fun, ha ha, what

a sense of humor he has), but really suggests the ab myo so that he

can be extra, extra careful to preserve my utereus.

I did a search on the internet, through Yahoo, and typed in uterine

fibroids. I will try to find all of the sites, but my links have

been erased for some reason. One was from a doctor at Brigham

Young, I think, and a few more.

Whatever you feel is best, do it. I do remember one site saying

that a few more weeks of recovery (lap vs. myo) was worth it in the

long run, to preserve your fertility. I've had two csections, and am

not worried about the ab myo being any worse, and I bounced back

very quickly from the csections, PLUS, I had a baby to care for! So,

I am all for the ab myo for the above reasons.

Let me know what you decide! Feel free to email me at

kim_k_2001@....

Kim

> Hi-

> Thanks for your help. I have a couple of questions below:

>

> > My dr explained that he

> > needs to be extra careful removing the fibroid, and stitching

> > everything back up, so that he preserves my utereus for future

> > pregnancy. He could do it laproscopically, but wouldn't be

assured

> > of maintaining the integrity of the utereus, he said. Lap myo's

are

> > best for women not wanting more kids, but wanting to keep their

> > utereus.

>

> Did your doc say why laps have a higher chance of compromising the

integrity of the uterus?

>

> > I've done a lot of research on this, and have read the same over

and

> > over.

>

> Do you have any good recs for places to get more info about this?

>

> > Good luck, and I'll let you know how my surgery goes. I go

under

> > the knife on Tuesday, and will hopefully be home by Thursday, or

> > Friday at the latest, dr. said. I'll let you know.

>

> Good luck!

>

> -Ann

[Guest guest]

Don't know if you saw this--another member posted this article.

Another reason for ab myo vs. lap myo, when it comes to fertility.

Read into a few pages, and they discuss the chance of uterine

rupture with lap myo, because the doc can't be as careful closing

the wound left from the fibroid. For what that's worth!

Kim

> Hi-

> Thanks for your help. I have a couple of questions below:

>

> > My dr explained that he

> > needs to be extra careful removing the fibroid, and stitching

> > everything back up, so that he preserves my utereus for future

> > pregnancy. He could do it laproscopically, but wouldn't be

assured

> > of maintaining the integrity of the utereus, he said. Lap myo's

are

> > best for women not wanting more kids, but wanting to keep their

> > utereus.

>

> Did your doc say why laps have a higher chance of compromising the

integrity of the uterus?

>

> > I've done a lot of research on this, and have read the same over

and

> > over.

>

> Do you have any good recs for places to get more info about this?

>

> > Good luck, and I'll let you know how my surgery goes. I go

under

> > the knife on Tuesday, and will hopefully be home by Thursday, or

> > Friday at the latest, dr. said. I'll let you know.

>

> Good luck!

>

> -Ann