FAS vs. Myomectomy

FAS vs Myomectomy 

This section compares
FAS to Myomectomy.

For greater detail on the
FAS procedure please visit the
Female Alternative Surgery section.



Female Alternative Surgery is a surgical procedure that encompasses numerous techniques to treat many different disease processes. It is not only used for removal of fibroid tumors (also known as Fibroids), but also for treating Adenomyosis, Ovarian cysts, and Endometriosis. There are differences between FAS and Myomectomy before, during and after surgery, as well. Traditional Myomectomy is a surgical procedure that primarily addresses superficial tumors of the uterus, or fibroids – for example pedunculated tumors that have a stalk and are separate from the uterine muscle, and easily reachable tumors on the outer surface of the uterus.
A high majority of FAS procedures are performed through a bikini incision to enhance cosmetic outcomes. Sometimes even very large fibroids with an enlarged uterus can be effectively treated this same way, avoiding a vertical incision. In traditional myomectomy, most surgeons will use a bikini incision, but with large tumors, they may elect to use an up and down incision to accommodate for the enlarged uterus.
The use of lasers in Female Alternative Surgery is common. The argon laser used in Female Alternative Surgery treats the disease with very little damage to normal tissue. In traditional surgery, a cautery device (hot point pencil) is used. Multiple, small incisions are made over the tumors to excise them. However, much of the normal tissue is burned and destroyed.
Female Alternative Surgery is multi-dimensional as it addresses all the potential problems associated with fibroid disease. Many times, abdominal hernias form as a result of very large tumors. Uterine prolapse can also develop as a result of the stretching of the uterine ligaments. Ovarian cysts are a common finding, as well. These are all repaired and an attempt is made to strengthen the abdomen through this low incision. In traditional surgery, many of these issues are overlooked and therefore remain unaddressed.
Female Alternative Surgery is a procedure that involves minimal blood loss. We have never had the need to transfuse a patient. The mainstay of the procedure are the various techniques used to control blood loss. In traditional myomectomy, surgery blood losses can be large and transfusions are frequent. Excision of deep tumors is not attempted because of the risk of bleeding and possible hysterectomy.
The purpose of Female Alternative Surgery is to remove as many large and small tumors as we can see and feel. In our experience, large and small tumors, as well as polyps, are frequently found in the endometrial cavity. In traditional myomectomy surgery, the endometrial cavity is never entered.
Recurrence rates range from 1-3%, and may possibly be as low as 0.2%. We have seen, and frequently operate on, women who have had one, sometimes two, previous traditional myomectomies. Modern literature states that with traditional myomectomy surgery, recurrence rates range from 12% to 64%. This raises the question of whether these tumors have arisen post surgery or were simply never discovered during the first or prior myomectomy.
It is well documented in textbooks and modern literature that adhesions start to form eight hours after the abdomen is closed. During Female Alternative Surgery, we utilize several special techniques to help discourage adhesions from developing. Traditional surgeons make little or no effort to prevent these adhesions from forming.
Unlike the myomectomy procedure, one of the goals of Female Alternative Surgery, especially in women of child-bearing are, is to whenever possible, preserve the reproductive organs in a way that will allow for conception after the procedure. Many women are told when they are first diagnosed with fibroid tumors not to treat them or, if the tumors are not bothersome, to wait and do nothing. Bleeding is the most significant reason that fibroid tumors are treated in a conservative manner. However, this ‘wait and see’ policy is the reason that gynecologists often say later that the tumors are now too large to remove and the patient requires a hysterectomy. Doctors also frequently recommend a hysterectomy because they believe that after a woman’s child-bearing years are over, she has no need to keep her uterus. These same reasons are also given to women with Endometriosis or uterine prolapse and Adenomyosis.