Recently, there are always some female patients and friends consulting uterine fibroid surgery is open good or laparoscopic surgery, do not want to open surgery, many doctors said open surgery to remove fibroids thoroughly, so they do not know how to be good, I will do a brief introduction to the two. Wang Xiaoyuan, Department of Obstetrics and Gynecology, Shandong Province Qianfo Mountain Hospital
With the development of medical technology, laparoscopic surgery has been widely developed in China, but not to the extent of popularity, that is, she is still a new type of surgery, not all gynecologists have the skills, but the superiority of small trauma, fast recovery, aesthetics, etc. is widely recognized, I personally think that laparoscopic minimally invasive is more reflected in the slight postoperative adhesions, no obvious postoperative abdominal pain, these are significantly lower than open These are significantly lower than open surgery, which can be fully reflected in some patients’ second or more surgeries. The difference is that open surgery is done by touching the small fibroids buried deep in the muscle layer, while laparoscopic surgery requires the operator to sense them through the operating instruments, while the feel of open surgery can be easily obtained, the feel of laparoscopic surgery requires the sensitivity and lumpectomy experience of the operator, so relatively speaking The laparoscopic surgery to remove fibroids will be missed, but for skilled laparoscopic surgeons the possibility of missing is not higher than open surgery, I have laparoscopically removed as many as 20 fibroids, 0.5-6 cm in diameter, usually 3-6 fibroids are removed, but fewer single ones, the largest fibroids once reached 12 cm.
According to statistics, the recurrence rate 5 years after myomectomy is 15% for open and 20% for laparoscopic, but there is no statistical difference between the two, even if there is recurrence, asymptomatic, and the diameter of myoma does not exceed 5 cm, there is no need to consider surgery, observation is sufficient. Post-operative recurrence includes post-operative leiomyoma leakage and recurrence. The leakage is the small leiomyoma less than 5 mm buried deep in the operation which is not easily detected by the operator and left behind and grows slowly in the future, and there is another one which is the leiomyoma that did not grow in the operation and grows again in the future. Therefore, Professor Zhang Zhenyu of Beijing Chaoyang Hospital advocates that since the recurrence rate after laparoscopic surgery is not significantly higher, laparoscopic surgery is still recommended from the perspective of minimally invasive aesthetics. I endorse this view, and since minimally invasive is minimally invasive to the end, I will only make three holes in the abdomen (one in the belly button to put the laparoscopic tip, one on the left and one on the right to operate) to complete the laparoscopic myoma resection surgery, which has good results, shorter operation time and less bleeding than open surgery.
The purpose of laparoscopic surgery and open surgery is the same, is to try to remove the clean myoma, but can not guarantee not to miss, not recurrence, there are conditions, doctor skilled to do laparoscopic surgery, can not reach the conditions not skilled enough to open, patient friends do not have to exist any more open to remove the clean psychology, feel free to choose your surgeon can, after all, laparoscopy or there is a slightly higher cost, but the most important point The most important thing is to do ultrasound at least once a year after 6 months of surgery.