Is FAS basically a myomectomy utilizing laser technology (in regards to fibroids)?

I understand this is an alternative to hysterectomies, but, is this an “alternative” for those of us whose doctors have recommended open abdominal myomectomies for intramural fibroids? Why did you say myomectomies only address superficial tumors? Intramural tumors aren’t considered superficial, are they? My doctor said the cavity would be examined and any other problems/tumors/cysts removed (he would have a laser available if needed). Would your procedure differ? A friend of mine (surgical nurse) said cutting is cutting whether it is with a laser or knife and said a laser is sometimes more of a gimic… When I think of “alternatives”, my mind goes to none invasive treatments. Have you ever heard of natural progesterone treatment being helpful? I don’t mean to be argumentative, just confused…

Dear Heather-
Our FAS procedure is a type of laser myomectomy. Our surgical techniques are what makes it different from other abdominal myomectomies.
The highest percentage of myomectomies only addresses very superficial tumors-the deeper and larger fibroids (intramural) are not commonly addressed by most gyns.Blood supply to these tumors can be extensive and many surgeons do not feel comfortable addressing these tumors for fear of blood loss and potential hysterectomy.
I use both lasers and cautery in my practice however the laser is used to specifically reduce tissue damage at the cellular level and to prevent blood loss. Both issues I feel are important in preserving the organ.

Dear Dr. DJ: A friend of mine told me about you–she’s scheduled for surgery with you on 10/16. She’s real excited and looking forward to it. My Dr. told me @ 1 year ago that I have fibroids, that my uterus is about 7″ in diameter (I don’t know how many months that translates into). She said we should take the wait and see approach. I’m not having any pain. However, I am 51 and have Type II diabetes, diagnosed @ 3 years ago. I was interested in reading that symptoms of fibroids include fatigue, menstrual problems, etc.because I thought I’ve been starting menopause–my period skipping months, then bleeding heavily for 54 days, then skipping, hot flashes, etc. I also thought that my fatigue was due to my diabetes, but now I’m not so sure–could all these symptoms be due to the fibroids, instead?

Dear Kkeiser-
With multiple concurrent issues, it is difficult to give you an exact reason for your symptoms. Most definitely your skipped periods are related to your menopause, and the lengthy cycles are due to your fibroids. Fatique is a very common symptom related to fibroid tumors, however, if your diabetes is not in check, this can lead to fatique as well. My impression is that if your tumors were removed you would feel considerably better-we do not believe in the “wait and see” approach. Once you begin hormone replacement therapy for your menopause your tumors will continue to grow. Please give my office a call if we can help you.

Dear Dr. del Junco Jr.-

I am 43 and was told by my doctor that my uterus is the size of 25+ week pregnancy; what size is that? I don’t know if he plans to do an open abdominal or FAS. I have had this tumor(s) since 1988 and have lots of fears about anesthesia and surgery itself; not to say worries about things that may be wrong; they are pushing me for surgery, but there’s a lot I don’t understand. My last monthly, I used 40 super tampons and 25 overnight pads. I know I must do something, but I am very afraid. Are there any FAS clinics located somewhere besides California? Of course, I suffer from fatigue.

Dear Gemi-
Basically, your uterus is the size of a large cantelope. Your symptoms and fatigue and very likely attributed to the size and number of your fibroids. You need to have surgery.
Our Institute is only located in California, and this procedure is performed no-where else in this country.
I am certain we can help you. Please call my office if you are interested.

Dear Dr.

I am so disappointed. I had a myomectomy in 1992 and the physician told me she had to leave two very small fibrods due to location. They now have grow my uterus is 18.4 cm I believe (4-5 wks). My doctor and I have been “monitoring” them for some years. I am 42 no children. during my last follow up and ultrasound, my doctor said (very matter a factly) that I have three choices 1. remove the uterus (since I’m not marry and have no prospects in sight for progreation. 2. Uterin Embolization, (which is choking all blood flow to my Uterus 3. Myomectomy which she NOW refuse to do because she said its big. What dissapoints me the most is that she was the one that told me to take the “wait and see” approach. Now I feel betrayed. I have no heavy bleeding, regular period (every 28 days, flow for 5 days). no back pains no bladder issues. I do have a blotted stomach. I want my uterus! what should I do! when I spoke to the radiologist that would perform the Embolization he said I do not fit the criteria for this procedures and said he would speak to my doctor to see why she would recommend this when I am not asymtomatic. Why would she want to remove the uterus but not perform the Myomectomy? Please help me understand!

Dear Moses-
Your gyn to probably not comfortable performing surgery on tumors of that size, or in that location. Most will immediately recommend a hysterectomy if they feel they cannot safely remove the tumors. You are definitely a candidate for FAS. Please call me office if you think we can help you.
Dr. DJ