Doç. Dr. Cengiz ANDAN
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Fibroids are among the most frequent diagnoses women hear during gynecological examinations. Seen in 1 out of every 4 women of reproductive age, these masses, although usually benign, can turn life into a nightmare with the complaints they create.
The first fear that comes to the mind of a woman diagnosed with fibroids is usually this: “If I have surgery, will they remove my uterus?” or “Will I be left with a huge scar on my belly?”
As Assoc. Prof. Dr. Cengiz Andan, we answer these concerns with technology and experience: No. Thanks to Laparoscopic Myomectomy (Closed Method Fibroid Removal), which is today’s gold standard, we can remove only the fibroids as easily as pulling a hair out of butter, without damaging your uterus. Moreover, with a scar-free technology that puts an end to your aesthetic concerns.
The Uninvited Guest: What is a Fibroid and Why Does It Create Problems?
Fibroids are benign tumors originating from the muscle layer of the uterus (myometrium) with an extremely low risk of becoming cancerous (0.1%). Although it is not exactly known why they form, it is known that they are sensitive to the estrogen hormone and have a genetic transition.
Not every fibroid requires surgery. However, if it gives the following symptoms, it must definitely be treated:
Uterus-Preserving Surgery: Laparoscopic Myomectomy
In the past, fibroid surgeries were performed by opening the abdomen like a C-section, and sometimes the patient’s uterus was also removed due to the risk of bleeding. Today, we act with the principle of “Organ Preserving Surgery.”
The process in the Laparoscopic Myomectomy procedure works as follows:
The removed fibroid is taken into a special bag (endobag) inside the abdomen. With a special device called a Morcellator, it is thinned into strips inside the bag and taken out through that small hole. So even if your fibroid is 10 cm, there is no need to cut your abdomen.
Why Should You Choose the Closed Method Instead of Open Surgery?
Laparoscopic myomectomy is not just an aesthetic choice, but a medical necessity. The advantages of the closed method carry vital importance, especially for women who are considering having children:
Fibroid Surgery and Pregnancy
The biggest fear of our patients is the question, “Can I have children after surgery?” Answer: Yes, it even becomes easier.A fibroid filling the inside of the uterus or creating pressure can prevent pregnancy or cause you to miscarry. Removing the fibroid relieves the uterus and provides a healthy environment for the baby to settle. The important thing is that the surgery is performed by experienced hands without damaging the uterus.
At Assoc. Prof. Dr. Cengiz Andan Clinic, our priority is to protect the uterus at all costs and to continue the woman’s chance of motherhood. Fibroids are your fate, but remaining without a uterus is not your obligation.
Since an incision and suturing process is performed on the uterine muscle tissue, the uterus needs to heal completely and strengthen. We generally recommend protection for 3 to 6 months after surgery. At the end of this period, you can safely plan a pregnancy.
Fibroids are structures formed with genetic predisposition. Even if existing fibroids are completely cleaned, the probability of new (recurrent) fibroids appearing from another part of the uterus within years is around 10-15%. However, this risk does not mean you should not have surgery. The process is managed with regular check-ups.
After laparoscopic myomectomy, Cesarean section is generally recommended as the delivery method. Because the incision made in the uterine wall may not withstand the high pressure during normal labor pains, and (although a very low probability) a risk of uterine rupture may occur. For the safety of the mother and the baby, a cesarean section is a more correct choice.
Technically, even fibroids up to 15-20 cm can be removed with the closed method. The limiting factor is not the size of the fibroid, but its number and location. If there are 20-30 large and small fibroids in the uterus, the open method may be preferred because the closed surgery would take too long. However, the closed method is ideal for 1-5 large fibroids.
This risk theoretically exists in every uterine surgery (open or closed), but in practical life, in the hands of an experienced surgeon, this probability is negligible. Only if there is uncontrollable bleeding that creates a life-threatening situation (a one in a thousand probability) may the uterus be removed. In experienced teams, this risk is close to zero.