This is one of the newer hot topics in surgical treatments. Considered minimally invasive, this technique uses several small incisions to remove tumors and repair the uterus. It requires special training prior to implementation. The physician operates instruments via a control panel and does not have direct hands on the patient, unlike open or laparoscopy procedures. Although recovery is much quicker than the traditional myomectomy, treatment can be limited due to the possibility of extensive bleeding during the procedure. The robot can be very successful for pedunculated and subserosal fibroids, but does have limitations for deep, larger intramural fibroid tumors.
I recently had a patient in the office with very large fibroids…she had had two previous myomectomies with her gynecologist and she was wondering why her tumors had returned. Sadly, the recurrence rates for fibroid tumors following surgery can be as high as 60%…the well known fact is that most of these tumors have not grown back since surgery, but were never removed during the inital procedures. Fibroids that are deep in the uterine muscle are difficult to access without significant blood loss…as a result, many gyns will not remove the deeper tumors. This sets women up for multiple fibroid tumor surgeries. Our recurrence rates are approximately 2%, as we are able to remove all fibroids, regardless of size or location (submucosal, subserosal) employing vascular techniques that prevent bleeding. If you are considering a myomectomy ask your doctor about their success rates, in reference to minimizing the need for future surgery.