Re: Has Anyone Had A Laparoscopic Myo w) Lg.Fibroids?

April 9, 2004

I believe I read on the list not that long ago one of our fellow

fibroidians who tried a lap myo but it was converted to open

abdominal myo during the procedure, you can probably find it if you

do a search.

I had what was thought to be 2-3 large fibroids (10 cm, 5-7 cm). I

researched laparoscopic myo also, and found a handful of references

for doctors who do this on very large fibroids, including Dr. Liu who

you mention. Another is a Dr. Nezhat at Mt. Sinai in NYC. There are

three Dr. Nezhat's around the country, all brothers, who all do

various types of laparoscopic gyne surgery. CONCERN HERE: one of them

has had some suits against him for surgery that went bad. Not the guy

in NYC, but research carefully. These guys are a bit controversial.

The doctor I ended up with (who does laparoscopic myos but not on

such big fibroids) said that there are basically literally a handful

of doctors around the country who do laparascopic surgery on such

large fibroids, and his opinion was that with such a small body of

experience you are basically having a procedure that is not well

studied, verging on experimental. Laparoscopic surgery is more time

consuming because the fibroid has to be cut up or " morcellated " to be

removed through the small incision(s). This would turn what is

generally a 1-3 hour abdominal surgery into significantly longer

laparascopic surgery. Longer surgery time and longer anesthesia time

also entail greater risk.

This " virtually experimental " point is consistent with what I read

about the Dr. Nezhat who had complaints against him -- this was not

for a myo, I can't recall the details but something gynecological

where he ended up also involving the rectum in a highly unorthodox

procedure and never told the patient (according to her) what he had

actually done. You can find this on the web, that's where I found it.

I'm not making a statement about this complaint or the Nezhats or any

doctor per se (I believe I read a post here by someone who had

laparoscopic myo with one of the Dr. Nezhat's, perhaps in Atlanta?,

and was very happy), and I'm not suggesting that a particular

procedure should be ruled out just because it's not commonly done or

is considered experimental. But we should carefully consider risks

and potential benefits.

In my case it turned out that what appeared on ultrasound to be 2-3

large fibroids were actually found during (abdominal myo) surgery to

be one HUGE fibroid, 27 cm (9 in), so any attempt to do a

laparoscopic procedure almost certainly would have (appropriately)

been converted to an open abdominal one. If you decide to proceed

with a laparoscopic procedure, I would insist on thorough MRI and

ultrasound studies (both) to be more certain what is actually there,

and my understanding is that even then it is not 100% certain. In

either case -- whether you have MORE fibroids than are seen

beforehand (which is most common) or if you end up having fewer but

bigger, as I did, it would impact on the ability to get out all the

fibroid mass in a reasonable surgical time-frame.

Having said all that (if you're still with me here!!!) -- if you do

go with Dr. Liu or even just get his opinion, please, post your

thoughts and results (or e-mail me privately). I am still very

curious about this kind of procedure and would like to see it better

studied and practiced in the future.

Best of luck in your research!

Sunny

In my ongoing search to find the procedure I would feel most comfortable w), I

have been trying to locate Drs. who do minimally invasive laparoscopic

myo's.on lg.fibroids, via small incision through the bellybutton; I have 2

> subserosal fibroids, 6 & 10 cm, the larger may be pedunculated. I

> found a website for Dr. Liu in NYC, who is highly skilled in this

> procedure; via email correspondence, he felt that I was a potential

> candidate. Has anyone w) lg. " roids " had this type of surgery? Does

> anyone have any input re: Dr. Liu?

April 9, 2004

My surgery was converted from lap. to open myo. I've written the

details many times and I hope that you can find them in the archives

(sorry, I can't bear to write the whole story again, there are a lot

of details, please understand that I've had to tell the story one too

many times!!!). Some points I want to make. 1.) In some ways it

was worth a shot to try the lap. and there was really no way of

knowing ahead of time that conversion would be necessary. It's a

risk that you just have to know about. 2.) The only thing I can say

about the open myo when I look back is that I had NO reason to fear

it the way I did and NO reason to go to great lengths to try to avoid

it. My lap. incisions were MORE PAINFUL and MORE VISIBLE than the

incision from the open surgery. Also, you will probably need 3

incisions for a laparoscopy, not just one. My healing time was

longer because of the fact that I had to have 2 surgeries in the same

day.

It is a VERY DIFFICULT decision that you have to make, get all the

info that you can and just remember that not everything is

predictable.

If you have questions, let me know. I'll do my best but I do hope

that you take the time to look for my name in the archives to get my

story.

Kerie (kerie0408)

April 9, 2004