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FAQ

How effective is minimally invasive surgery in treating uterine fibroids?

Minimally invasive surgery is effective in treating uterine fibroids and has multiple advantages. According to multiple studies and clinical data, laparoscopic myomectomy (LM) is one of the most widely used minimally invasive treatments.

First of all, compared with traditional laparotomy, LM surgery has obvious advantages such as less trauma, less bleeding, and faster recovery.
. Specifically, the incisions of LM surgery are smaller, and only 2-3 small incisions of 1-2 cm are needed to complete the entire surgical process, which greatly reduces the patient's pain and postoperative recovery time.

. In addition, since the operation is performed in the abdominal cavity, the damage to surrounding tissues is less, so the postoperative pain of the patient is less, and the hospitalization time is also significantly shortened.
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Secondly, LM surgery can effectively reduce the incidence of intraoperative and postoperative complications. Studies have shown that compared with open surgery, LM surgery has less intraoperative bleeding and a lower incidence of postoperative complications such as infection and adhesions.

. For example, in one study, patients in the observation group had higher postoperative TAC (total cholesterol) and E2 (estradiol) levels, while lower levels of inflammatory factors such as IMA, Myo, and SP, and the difference was statistically significant (P< 0.05), indicating that LM surgery can significantly improve traumatic response indicators, pain biochemical indicators and ovarian function indicators
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In addition, LM surgery also preserves the patient's fertility and has less impact on ovarian function. This is an important consideration for patients who wish to preserve their uterus and fertility

. Some improved LM techniques even further improve the success rate and safety of the surgery by continuously suturing the fibroid body and combining it with manual removal of the tumor body.
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In addition to LM surgery, other minimally invasive treatment methods such as transvaginal myomectomy (TVRM), high-intensity focused ultrasound (HIFU) ablation, and uterine artery embolization (UAE) are also widely used in clinical practice. These methods also have the advantages of less trauma, faster recovery, and can effectively control symptoms and reduce the size of fibroids.
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In summary, minimally invasive surgery is excellent in the treatment of uterine fibroids, especially laparoscopic myomectomy, which has become the preferred treatment method due to its advantages of less trauma, faster recovery, and fewer complications. For patients who need to preserve the uterus, choosing an appropriate minimally invasive surgical method can achieve the best therapeutic effect.
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What are the long-term effects and patient satisfaction of minimally invasive surgery to treat uterine fibroids?

Long-term outcomes and patient satisfaction with minimally invasive surgery for uterine fibroids are generally positive, but multiple factors need to be considered.

From the perspective of surgical results, laparoscopic myomectomy (LM) has significant advantages over traditional open surgery. This method has less trauma, less intraoperative bleeding, and shorter postoperative recovery time.

. In addition, the patient's quality of life basically recovered within two weeks after surgery, and was only negatively correlated with the number and volume of fibroids.

. This suggests that LM is an effective treatment for patients with uterine preservation needs
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Regarding the incidence of complications, although there is a certain risk, such as nausea and vomiting, vaginal discharge and pelvic infection, these conditions are relatively rare.

. For example, in minimally invasive ultrasound-guided microwave ablation treatment, the postoperative complication rates were 1 case of nausea and vomiting and 1 case of pelvic infection

. In contrast, other studies have shown that LM surgery has shorter mean operative times, less blood loss, and shorter incision lengths
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From the perspective of patient satisfaction, rapid recovery care has a significant impact on improving patients’ postoperative recovery and reducing complications.

. In addition, the patient's postoperative quality of life assessment showed that the quality of life gradually improved after surgery, and no significant correlation was found with the operation time, intraoperative blood loss, or chief symptoms.

. This further illustrates the effectiveness of minimally invasive surgery in improving patient satisfaction.

However, it should be noted that despite the many advantages of minimally invasive surgery, some patients still experience recurrence after surgery. For example, although uterine artery embolization can improve the quality of life of patients with symptomatic uterine fibroids, it carries the risk of re-intervention in the long term.

. Therefore, when choosing a treatment plan, doctors need to make individualized assessments based on the patient's actual situation.

The long-term effects and patient satisfaction of minimally invasive surgery for the treatment of uterine fibroids are generally good, but the potential recurrence risk and complication management still need to be paid attention to.

How does the cost-effectiveness of minimally invasive surgery compare with traditional laparotomy in the treatment of uterine fibroids?

The cost-effectiveness of minimally invasive surgery, such as laparoscopic myomectomy, versus traditional open surgery in the treatment of uterine fibroids is a complex issue. We can analyze it from multiple angles.

First of all, from the clinical effect point of view, laparoscopic myomectomy has the advantages of less trauma, less bleeding, and faster recovery.
. These features not only reduce patient pain and discomfort, but also significantly improve postoperative recovery speed and safety.

. In addition, this surgical method can optimize perioperative indicators, reduce the incidence of complications, and reduce damage to ovarian function.

. These advantages make laparoscopic surgery excellent in the treatment of uterine fibroids.

However, although laparoscopic surgery is superior to traditional open surgery in many ways, it is also relatively costly. This is mainly reflected in the following aspects:

Equipment and operating costs: Laparoscopic surgery requires expensive equipment support, such as the da Vinci robotic system, which is expensive and has low efficiency, limiting its clinical promotion.
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Physician skill requirements: Laparoscopic surgery requires surgeons to have a high technical level and experience, which further increases the cost of surgery
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Length of stay and medical costs: Although laparoscopic surgery can shorten hospital stays and reduce postoperative complications, patients still incur higher medical costs.
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In contrast, traditional laparotomy surgery, although more invasive, requires longer recovery times, and carries a higher risk of complications, may be more economical in certain circumstances. For example, in some complex cases or where extensive resection is required, open surgery may be more appropriate
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Taken together, laparoscopic myomectomy has obvious advantages in improving treatment effects, reducing complications, and accelerating recovery, but its high equipment and operating costs and the need for highly skilled doctors make it less cost-effective. traditional laparotomy
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What is the incidence of uterine fibroid recurrence after minimally invasive surgery?

According to the available data, there are no clear and unified data on the incidence of uterine fibroid recurrence after minimally invasive surgery. However, some information can be inferred from related studies:

The 5-year recurrence rate after conservative surgery is 36% to 50%. 27% of endometriosis patients require re-operation within 4 years after the first operation, and as high as 27% for those who have undergone 3 operations.
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The recurrence rate after semi-radical surgery is 57.1%, while the recurrence rate after radical surgery is 1% to 9%.
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Although these data refer primarily to other types of surgeries and diseases (such as endometriosis), they provide some reference value. Therefore, it can be speculated that in some cases, the recurrence rate of uterine fibroids may be higher, especially if the disease is not completely cured.

What are the differences in the effects of minimally invasive surgery for different types of uterine fibroids (such as mucosal, adenomatous, etc.)?

For different types of uterine fibroids (such as mucosal, adenomatous, etc.), the effects of minimally invasive surgery vary significantly. The following is a detailed analysis of the effects of minimally invasive surgery on different types of uterine fibroids based on the information I searched:

Submucosal uterine fibroids:

Type 0, type Ⅰ and type Ⅱ submucosal uterine fibroids: hysteroscopic resection of uterine fibroids (TCRM) is the main method to treat these types of fibroids, with the advantages of preserving the uterus, shortening the operation time, reducing intraoperative bleeding and accelerating postoperative recovery Etc
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Type II submucosal uterine fibroids: Due to their close contact with the myometrium, the operation is more difficult, takes longer, and causes more intraoperative bleeding.
. In addition, type II fibroids are significantly different from type 0 and type I in terms of postoperative anemia rate, operation time, and intraoperative blood loss.
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Adenomatous uterine fibroids:

The method of resection of adenomatous uterine fibroids depends on their encapsulation. When there is no capsule, resection is appropriate; when there is obvious capsule, resection is necessary.
. For fibroids that are embedded in the muscle layer, surgery needs to be performed under ultrasound monitoring.
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Other types of uterine fibroids:

For cases with multiple adhesions, large diameters (eg >10 cm), special locations, or severe pelvic adhesions, laparotomy may be required to reduce the risk of uterine rupture in future pregnancies.
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Taken together, hysteroscopic resection (TCRM), as a minimally invasive surgical method, has excellent performance in the treatment of submucosal uterine fibroids, especially for type 0 and type Ⅰ fibroids, and its effect is more obvious.

What are the latest research findings on the safety and complications of minimally invasive surgery to treat uterine fibroids?

According to the available data, the latest research findings on the safety and complications of minimally invasive surgery for the treatment of uterine fibroids include the following:

Single port laparoscopic surgery (SPLM):

SPLM has shown high safety and effectiveness in treating complex uterine fibroids. For example, Yong Yuanyuan et al. reported 80 cases of SPLM applied to complex uterine fibroids in 2021. All operations were successfully completed, proving its applicability in difficult operations.
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Compared with traditional multi-port laparoscopic surgery, single-port laparoscopic surgery has the advantages of less postoperative pain, faster recovery, and reduced risk of damage to vital organs and tissues.
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Although the operation time of SPLM is prolonged, there is no significant statistical difference in intraoperative blood loss, postoperative hospitalization time, and complication rate, indicating that it is safer.
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Magnetic Resonance Guided Focused Ultrasound (MRgFUS):

MRgFUS is a minimally invasive treatment method that uses magnetic resonance imaging for precise target organ localization. This method ensures the safety of treatment through real-time temperature feedback, and the immediate postoperative enhanced magnetic resonance examination can evaluate the treatment effect. Studies have shown that MRgFUS is safe and effective in treating symptomatic uterine fibroids and is expected to become a non-surgical treatment method.
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Hysteroscopic resection (TCRM):

TCRM is mainly used for the treatment of submucosal uterine fibroids. Based on clinical data from the Maternal and Child Health Hospital of Wannan Medical College from 2012 to 2015, this method is effective in treating different types of fibroids, but when dealing with larger or deeper fibroids, the operation may need to be stopped midway to avoid serious complications. complication
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High-intensity focused ultrasound (HIFU) and magnetic resonance imaging (MRI) both show good application prospects in the evaluation of treatment effects. They can clearly display fibroids and the non-perfusion range after HIFU, thus improving the accuracy and safety of treatment.
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Other minimally invasive surgical methods:

Minimally invasive surgical methods such as ultrasound-guided transcervical ablation and laparoscopic uterine myomectomy (transvaginal hysterectomy) are also constantly being researched and applied. These methods are comparable in efficacy to traditional open surgery. comparatively superior
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Transumbilical single-port laparoscopic myomectomy (TU-LESS) has also shown a good safety profile, with high postoperative incision satisfaction and low postoperative pain and body image disturbance scores despite longer surgical time.
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Potential risks and complications:

Although minimally invasive surgery has many advantages, it also carries certain risks and complications. For example, uterine fibroids thought to be benign before surgery may be diagnosed as malignant or potentially malignant after being morcellated during minimally invasive surgery. This indicates that fibroids with unclear postoperative pathological examination results should be re-explored as soon as possible to reduce intra-abdominal tumor dissemination. risk of dispersion
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Other common complications include heavy bleeding, wound infection, pelvic infection, endometrial adhesions, incomplete removal of fibroids, recurrence, damage to the ovaries, bladder or intestines, etc.
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Minimally invasive surgery to treat uterine fibroids has a good safety profile, especially emerging methods such as single-port laparoscopic surgery and magnetic resonance-guided focused ultrasound technology.

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