Laparoscopic Myomectomy for Fibroids Treatment in India at Aastha Healthcare Hospital

Fibroids are growths of tissue that are usually found in the wall of the uterus, or womb. They are made of a mixture of muscle tissue from the uterus and threadlike fibres of connective tissue. They are among the most common tumours in women. These growths aren't associated with cancer. The Medical names for a fibroid are leiomyoma, myoma, and fibromyoma.

They are one of the most common tumours found in women during their reproductive years. As many as three out of four women have fibroids, but most are unaware of them. Your doctor may discover them incidentally during a pelvic exam or prenatal ultrasound. Fibroids cause symptoms for about one in four women, most frequently during their 30s or 40s. But surprisingly they are the single most common cause for hysterectomy, being responsible for somewhere between 20% and 77% of all hysterectomies performed.

Uterine fibroids originate from the smooth muscle cells of the myometrium. A single cell reproduces repeatedly, eventually creating a pale, firm, rubbery mass distinct from neighboring tissue. Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

Types of Fibroids :

The names of fibroids reflect their orientation to the uterine wall. Basically, fibroids can be classified into four types. They are:

Intracavitary Myomas- These fibroids are present inside the cavity of the uterus. They usually cause bleeding between periods and often cause severe cramping.

Submucous Myomas- They are present partially in the cavity and partially in the wall of the uterus. They too can cause heavy menstrual periods as well as bleeding between periods.

Intramural Myomas- These fibroids are in the wall of the uterus, and can range in size from microscopic to larger than a grapefruit. Many of these do not cause problems unless they become quite large. There are a number of alternatives for treating these, but often they do not need any treatment at all.

Subserous Myomas- They are on the outside wall of the uterus. A fibroid may even be connected to the uterus by a stalk. These do not need treatment unless they grow large, but they can twist and cause pain

For more information on Laparoscopic Myomectomy for Fibroids Treatment, kindly visit :
http://www.aasthahealthcare.com/Laparoscopic-Myomectomy-Fibroids-Treatment.htm

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Diagnostic Laparoscopy Treatment in India only at Aastha Healthcare Hospital

What is diagnostic laparoscopy?

Laparoscopy is a minimally invasive procedure which is used for both surgical and diagnostic purposes. When laparoscopy is used for diagnosis, it is called diagnostic laparoscopy. This is used when a diagnosis is in doubt and this procedure can provide the needed information to the surgeon.

Technological advances in equipment over the last decade have revolutionised the approach to traditional diagnostic ways for gynaecological problems. Today, at Aastha Health Care, Diagnostic Laparoscopy is one of the most commonly performed gynaecological procedures.

In this procedure, the surgeon makes small incisions and inflates the abdomen with gas (carbon dioxide) to enlarge the size of the viewing area. After this, a laparoscope or small camera is inserted. A laparoscope is a thin tube with a light and tiny camera and it projects images of the abdomen onto a high resolution television screen. By mobilizing the camera, the surgeon can have a very thorough look through the abdomen without the pain and recovery of a larger incision. During this, the surgeon can look directly at the outside of the uterus, ovaries, fallopian tubes, and nearby organs.

For more information on Diagnostic Laparoscopy Treatment India, kindly visit :
http://www.aasthahealthcare.com/Diagnostic-Laparoscopy-Treatment.htm

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Minimally Invasive Procedure for Haemorrhoid (MIPH) Treatment | Piles Treatment | Haemorrhoid Treatment | Aastha Healthcare | Super Speciality Center

What are haemorrhoids?

Haemorrhoids are one of the most commonly occurring ailments, affecting both men and women. One reason people do not talk about haemorrhoid problems with their doctors is because they anticipate a painful, traditional haemorrhoid surgery. But the fact is that better understanding of the disease process along with new technological improvements; have enabled more procedures to be performed as day care procedure. Piles or Haemorrhoids can occur at any age. Many experts believe that they are caused by continuous high pressure in the veins of the body, which occurs because humans stand upright. The causes of haemorrhoids include constipation and excessive straining during bowel movements. Persistent diarrhoea and loose stool movements are also causes of haemorrhoids, and some people inherit a family tendency to develop piles. Women are more susceptible to haemorrhoids during pregnancy, as pressure from the growing uterus restricts blood flow in the pelvic area. Lifestyle factors can also contribute to haemorrhoid development.

Haemorrhoids may be internal or external. Both types of haemorrhoids can be present at the same time. Internal haemorrhoids are classified further based upon the degree to which they protrude from the anal canal. This grading system is important since the grade in part determines which type of treatment is best. But no widely used grading system exists for external haemorrhoids. According to this grading system:

Grade I haemorrhoids may bulge into the anal canal but do not protrude through the anus. Grade II haemorrhoids protrude through the anus during straining and defecation, but return spontaneously. Grade III haemorrhoids protrude through the anus with defecation or straining but do not return spontaneously, requiring the patient to gently push it back into its normal position with a finger. Grade IV haemorrhoids cannot be manually returned to their normal position.

What are the symptoms of piles?

The symptoms of piles can come and go. There are five main symptoms:

Itching and irritation Aching pain and discomfort Bleeding A lump, which may be tender Soiling of pants or knickers with slime or faeces ('skid marks').

Itching and irritation probably occur because the lumpy piles stop acting as soft pads to keep the mucus in; instead, a little mucus leaks out and irritates the area around the anus. Pain and discomfort comes from swelling around the pile, and from scratching of the lining of the anal canal by faeces as they pass over the lumpy area. The scratching also causes bleeding, which is a fresh bright red colour and may be seen on faeces or toilet paper or dripping in the pan. A pile that has been pushed down (a second- or third-degree pile) may be felt as a lump at the anus. Internal haemorrhoids cannot cause cutaneous pain, but they can bleed and prolapse. Prolapse of internal haemorrhoids can cause perianal pain by causing a spasm of the sphincter complex. This spasm results in discomfort while the prolapsed haemorrhoids are exposed. The discomfort is relieved with reduction. Internal haemorrhoids can also cause acute pain when incarcerated and strangulated. Again, the pain is related to the sphincter complex spasm. See the table given below to know the symptoms of specific types of haemorrhoids:

Type Symptoms Internal haemorrhoid symptoms May protrude Mucous discharge Rectal bleeding Rectal itching Feeling of incompletely emptying bowels. External haemorrhoid symptoms Rectal itching uncommon May protrude Rectal bleeding Interferes with anal hygiene. Thrombosed haemorrhoid symptoms Protrudes Rectal itching Rectal pain Rectal bleeding Tenderness Swelling. Ulcerated haemorrhoid symptoms Rectal itching Rectal bleeding Swelling Severe rectal pain. Bulge of Internal Piles Bleeding of Internal Piles

How is it diagnosed?

Haemorrhoids are diagnosed based upon a history, physical examination and visual inspection of the anal canal and rectum. When the patient reports to the physician with the symptoms of piles, the physician takes detailed case history.

To confirm presence of haemorrhoids, the doctor will do a rectal examination. The doctor will place a gloved and lubricated finger into the rectum to feel for abnormalities. External haemorrhoids can be diagnosed by a visual and/or rectal examination. To diagnose internal haemorrhoids, the doctor will insert a thin tube-like instrument (called an anoscope) into the lower few inches of the rectum. The anoscope has a light at the end and an eyepiece at the front for viewing into the anal canal. The procedure is painless but uncomfortable and lasts about 1 minute and is done in the OPD. Despite the fact that bleeding is common in patients with haemorrhoids, other potential causes of bleeding are excluded. To test for blood that may not be visible, the clinician obtains a small stool sample on a gloved finger. The stool is smeared onto a chemically coated paper and drops of another chemical are added. If blood is present, the colour of the paper will change to blue.

A more detailed look can be done by a procedure called sigmoidoscopy that is done under sedation or anaesthesia and a look upto 25 cm can be done to rule out any sinister disease that may be associated. Occasionally, a barium examination or colonoscopic examination of the large intestine may be required if other diseases are suspected.

What are the treatment options?

Several options are available for the treatment of haemorrhoids. For many, conservative or minimally invasive measures are effective in relieving symptoms. But in many cases, the physician may ask the patient to undergo the surgery.

Conservative Method

Increasing fibre in the diet is one of the best ways to soften and bulk the stool, which can help to reduce bleeding from haemorrhoids. The physician may also prescribe fibre supplementation. These products work by absorbing water and increasing stool bulk, which increases the frequency of bowel movement and softens stool. For grade II piles, Sitz bath will be recommended. The rectal area is immersed in warm water for 10 to 15 minutes two to three times daily. Pain-relieving creams and suppositories are also given to give temporary relief.

OPD / Alternate Procedure

Patients who have bothersome haemorrhoid symptoms, despite trying conservative measures, may consider a minimally invasive procedure. Most procedures are performed as a day surgery, allowing a patient to go home in the afternoon or evening. The following procedures are intended for treatment of internal haemorrhoids:

Rubber band ligation - Rubber band ligation is the most widely used procedure, and is best suited for grade I, grade II, and certain grade III internal haemorrhoids. Rubber bands or rings are placed around the base of an internal haemorrhoid. As the blood supply is restricted, the haemorrhoid shrinks and degenerates over several days. Many patients report a sense of "tightness" after the procedure, which may improve with warm sitz baths.

Laser, infrared, or bipolar coagulation - These methods involve the destruction of internal haemorrhoids with laser or infrared light or heat. Coagulation causes the haemorrhoidal tissue to harden and degenerate, and to form scar tissue as the area heals. Coagulation is generally effective for grade I and grade II internal haemorrhoids. In a technique called Haemorrhoidolysis, therapeutic galvanic waves are applied directly to the haemorrhoid, to shrink and dissolve the tissue.

Sclerotherapy - During sclerotherapy, a chemical solution is injected into haemorrhoidal tissue, causing inflammation, degeneration, and scar formation.

Cryosurgery- This freezes the pile to destroy it. It is not used much, because it causes a watery discharge afterwards.

Surgical Method

Patients who continue to experience symptoms despite conservative or minimally invasive therapies typically require surgical removal of haemorrhoids (haemorrhoidectomy). Surgery is the treatment of choice for patients with symptomatic grade IV internal haemorrhoids or strangulated internal haemorrhoids. Now under this, there are again two ways for doing it:

Conventional or open method New method or MIPH method

Conventional method

Surgery to remove haemorrhoids is called haemorrhoidectomy. During this, the doctor makes incisions around the anus to cut away the haemorrhoids. It involves the surgical removal of excess haemorrhoidal tissue and anal canal lining. Most anal surgeries are being done under general or regional anaesthesia. Most patients experience some degree of pain following the surgery. It is painful for 7-10 days afterwards.

While surgery usually relieves the pain, swelling, bleeding, and itching caused by haemorrhoids, a drawback to this procedure is that the incisions are made in a highly sensitive area and might require stitches, which can cause the area to be tender and painful. In addition, patients might have some trouble urinating because the pain following surgery makes it difficult to relax and allow urine to flow.

New Method or stapler haemorrhoidectomy

In the past, open surgery was the only option available to surgeons when they needed to see inside a patient's body or remove or repair and organ. But today, minimally invasive technology is completely changing the way doctors approach patient care. While conventional surgical haemorrhoidectomy is a safe and reliable procedure, it is often associated with significant postoperative pain. A new procedure for removing large haemorrhoids, the stapler haemorrhoidectomy, is less painful and allows patients to return to work and other normal activities much earlier than with the conventional procedure. Stapled Piles Surgery is also known as PPH (procedure for prolapse and haemorrhoids) or MIPH (Minimally invasive procedure for haemorrhoids). The PPH procedure was first introduced in Italy in 1997 and in the last four years has become very popular all over the world.

This technique uses a stapling device and takes advantage of the fact that pain-sensing nerve fibres are absent higher in the anal canal. In this procedure, the mucosa above the dentate line, which contains part of the pile mass, is excised and stapled with the stapler gun, thus taking care of bleeding and prolapse - the two major components of piles. The pile masses are compressed into a cup like cavity inside the stapler. When fired, the titanium staples cut and seal simultaneously, thus causing minimal bleeding and as the cut line is above the nerves, there is reduction in post operative pain. Additionally there is no incision on the perianal skin or lower part of anal canal and the wound in the anal mucosa is also primarily closed with a stapler, thus, there is no need to do any post operative dressing. It can be done as an outpatient, using local anaesthesia with intravenous (IV) sedation. Routine preoperative workup for these techniques is required. Simple distal rectal evacuation is required for a clean operative field. Distal rectal evacuation is best achieved by small-volume saline enemas. But it should be done by a surgeon who is especially trained in doing stapler surgery. This is because there are few risks associated with the unskilled hands. The risks include: damage to the rectal wall, overstretching of sphincter muscles. etc.

Benefits and drawbacks

Studies suggest that Stapled Piles Surgery (also known as PPH - procedure for prolapse and haemorrhoids or MIPH - Minimally invasive procedure for haemorrhoids) is an effective treatment. This technique potentially provides a tool for reducing some of the problems associated with conventional surgery. It considerably reduces operative bleeding, postoperative pain, the length of hospital stay, and encourages a rapid return to normal activities when compared with conventional piles surgery. So the clear advantages of the modern methods for outpatient treatment of internal piles are that they are quick and relatively painless. Patients lose little if any time from work, the complications are minor, and the cure rates are high. So to summarise, given below are the advantages of MIPH in points:

Smaller incisions resulting in reduced pain and discomfort Minimal scarring Greater surgical precision Fewer complications Less blood loss and a decreased need for blood transfusions Reduced risk of infection Shorter hospital stays Faster recoveries

Care to be taken at home

While no strategy completely removes the risk of haemorrhoids occurring again, following these suggestions can lower the risk:

Avoid straining during bowel movements. Avoid constipation Drink enough liquid for proper hydration. Eat a diet high in fibre. Exercise regularly. For more information, kindly visit : http://www.aasthahealthcare.com/Minimally-Invasive-procedure-for-Haemorrhoid-MIPH-Treatment.htm ------------------------------------

Laparoscopic Myomectomy Treatment for Fibroids | Obstetrics Surgical Treatment | Gynaecology Surgical Treatment | Aastha Healthcare | Super Speciality

What are Fibroids?

Fibroids are growths of tissue that are usually found in the wall of the uterus, or womb. They are made of a mixture of muscle tissue from the uterus and threadlike fibres of connective tissue. They are among the most common tumours in women. These growths aren't associated with cancer. The Medical names for a fibroid are leiomyoma, myoma, and fibromyoma. They are one of the most common tumours found in women during their reproductive years. As many as three out of four women have fibroids, but most are unaware of them. Your doctor may discover them incidentally during a pelvic exam or prenatal ultrasound. Fibroids cause symptoms for about one in four women, most frequently during their 30s or 40s. But surprisingly they are the single most common cause for hysterectomy, being responsible for somewhere between 20% and 77% of all hysterectomies performed. Uterine fibroids originate from the smooth muscle cells of the myometrium. A single cell reproduces repeatedly, eventually creating a pale, firm, rubbery mass distinct from neighboring tissue. Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

Types of fibroids

The names of fibroids reflect their orientation to the uterine wall. Basically, fibroids can be classified into four types. They are: Intracavitary Myomas- These fibroids are present inside the cavity of the uterus. They usually cause bleeding between periods and often cause severe cramping. Submucous Myomas- They are present partially in the cavity and partially in the wall of the uterus. They too can cause heavy menstrual periods as well as bleeding between periods. Intramural Myomas- These fibroids are in the wall of the uterus, and can range in size from microscopic to larger than a grapefruit. Many of these do not cause problems unless they become quite large. There are a number of alternatives for treating these, but often they do not need any treatment at all. Subserous Myomas- They are on the outside wall of the uterus. A fibroid may even be connected to the uterus by a stalk. These do not need treatment unless they grow large, but they can twist and cause pain

What are the causes?

A fibroid starts as a single muscle cell in the uterus. For reasons that are not known, this cell changes into a fibroid tumor cell and starts to grow and multiply. Heredity may be a factor. After puberty, the ovaries produce more hormones, especially oestrogen. Higher levels of these hormones may help fibroids to grow, although exactly how this might happen is not understood.

What are the symptoms?

Surprisingly most fibroids up to the size of an orange cause no symptoms. Their mere presence is not a reason to treat them. Only about a quarter of women with fibroids will experience any symptom. These may include:

Heavy and painful periods- Periods may last more than seven days and menstrual flow may be very heavy. Pain during sexual intercourse, Infertility- Large intramural fibroids may be the cause of longstanding infertility if all other causes have been excluded. Urinary or bowel symptoms caused by local pressure due to the fibroids. Complications in pregnancy like miscarriage, premature labour Pain in the pelvis-The pressure of large fibroids on other organs may cause pain in the pelvis. Pain may also occur if the stalk of a fibroid twists, cutting off blood supply to the fibroid. Rarely, a fibroid may become infected and cause pain. Very rarely, a fibroid can undergo malignant change, particularly if the fibroid is very large or rapidly increases in size.

We have already discussed above the various types of fibroids that can arise. Let us see separately what kind of symptoms will be presented by each of them.

Intracavitary Myomas- These fibroids are present inside the cavity of the uterus. They usually cause bleeding between periods and often cause severe cramping.

Submucous: They protrude into the uterine cavity and cause menstrual cramps, heavy periods, infertility and repeated miscarriages. The diagnosis is often missed as the uterus is not enlarged and unnecessary hysterectomies have been performed for these. The diagnosis is made by hysterosonography or hysteroscopy.

Intramural: These fibroids are within the muscle of the uterus and can be very large. Because they enlarge the cavity of the uterus they can also cause heavy periods. The most common problem is 'pressure' symptoms on the bladder and rectum.

Subserous: These are external to the uterine muscle and are connected by a thin stalk. They are the least likely to be symptomatic and rarely need removal. Torsion (twisting) is a very rare complication.

How are they diagnosed?

One of the most common conditions confused with fibroids is adenomyosis. This can be a serious error, as the treatment may be quite different. In adenomyosis the lining of the uterus infiltrates the wall of the uterus, causing the wall to thicken and the uterus to enlarge. This can cause severe pain, and heavy bleeding. Since they present in the same way as fibroids, they often lead to wrong diagnosis. So after the gynaecologist takes the case history, the first step is to do a thorough pelvic examination. Fibroids may be felt during a pelvic exam, but many times myomas that are causing symptoms can be missed if the examiner relies just on the examination. So after this, the physician may ask the patient to undergo the following test:

Ultrasound

On ultrasound examination adenomyosis will often appear as diffuse thickening of the wall, while fibroids are seen as round areas with a discrete border.

Hysteroscopy

Hysteroscopy uses a hysteroscope, which is a thin telescope that is inserted through the cervix into the uterus. Modern hysteroscopes are so thin that they can fit through the cervix with minimal or no dilation. Because the inside of the uterus is a potential cavity, like a collapsed air dome, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see. During diagnostic hysteroscopy the hysteroscope is used just to observe the endometrial cavity (inside of the uterus.)

MRI scan

The above steps are usually all that is needed to make an accurate diagnosis and plan treatment. Sometimes, especially with very large fibroids, more information is needed. An MRI scan makes detailed images of the uterus. It can show the location of fibroids. An MRI can usually tell the difference between adenomyosis and fibroids.

What are the treatment options?

There's actually no single-best approach to treating fibroids. The option that's best for you depends on many factors. Your plans for childbearing, how close you are to menopause and your feelings about surgery may play a role in determining your options.

Watchful waiting

Fibroids that cause no symptoms may require only "watchful waiting". In this, your gynaecologist will monitor your condition through regular pelvic examinations. It is also a good option if one is approaching menopause.The reproductive hormones oestrogen and progesterone appears to stimulate fibroid growth. During menopause, the ovaries stop producing these hormones and fibroids shrink. Your gynaecologist may decide to take action if signs and symptoms such as heavy bleeding, pelvic discomfort and pressure on neighboring organs start intruding on your life. Treatment depends on the size and site of the fibroids. The options include:

Drug Therapy

Drug therapy is usually tried first. This might include:

The use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) or naproxen sodium (Naprosyn), Birth-control pills, or Hormone therapy.

In some patients, symptoms are controlled with these treatments and no other therapy is required. However, some hormone therapies can have risks and side effects (menopausal symptoms, erratic or no menstruation, bloating, moodiness) when used long-term, and generally are used temporarily. Hormonal therapy can be useful for women who are close to the menopause and wish to avoid surgery. But hormonal treatment is unlikely to be of any benefit in women who wish to conceive and causes unnecessary delays.

A newer group of drugs being used for fibroids are hormones known as GnRH analogues, which are administered by injection by the gynecologist. These synthetic (man-made) hormones act like the hormones that are naturally produced by the body and reduce the level of oestrogen. The result is reduced blood flow to the uterus and, therefore, to the fibroids, decreasing the size of both. Some physicians recommend these hormones prior to surgery to reduce the size of the fibroids and make them easier to remove. The effectiveness of the hormones is considered temporary as studies show that when the therapy is stopped, fibroids regrow to their original size in four to six months. The GnRH hormones also may cause side effects that mimic menopause, including hot flashes, vaginal dryness, mood swings and a decrease in bone density (osteoporosis).

Minimal invasive procedures

Myomectomy is a surgical procedure that removes visible fibroids from the uterine wall. Myomectomy is the removal of fibroids without removing the uterus. This operation preserves a woman's ability to bear children. There are several ways to perform myomectomy, including hysteroscopic myomectomy, laparoscopic myomectomy and abdominal myomectomy. While the first two are minimally invasive procedures, the latter one is a traditional method.

While myomectomy is successful in controlling symptoms about 80 percent of the time, the more fibroids there are in a patient's uterus, the less successful the surgery generally is. In addition, fibroids grow back several years after myomectomy in 10 percent to 30 percent of cases.

Laparoscopic myomectomy

The surgical removal of fibroids is called a myomectomy. Laparoscopic myomectomy may be used if the fibroid is on the outside of the uterus. Intramural and subserous fibroids up to 10 cm in diameter can be removed by laparoscopic myomectomy, through two small incisions 10 mm in length, one in the umbilicus (navel) and the other a little lower down in the midline of the abdomen. Two smaller incisions only 5mm in length are made, one on either side of the abdomen about three inches from the midline. Presently only a handful of surgeons in this country offer this procedure which takes much longer and is more challenging than conventional surgery. Aastha specializes in such kind of minimal invasive procedures. Fibroids that are deep in the wall of the uterus or submucous are most difficult to remove laparoscopically.

Hysteroscopic myomectomy

This procedure is used only for fibroids that are just under the lining of the uterus and that protrude into the uterine cavity. Hysteroscopic myomectomy is performed through the woman's cervical canal and does not involve any abdominal incisions. During operative hysteroscopy a type of hysteroscope is used that has channels in which it is possible to insert very thin instruments. These instruments can be used to remove polyps, to cut adhesions, and do other procedures. In many situations, operative hysteroscopy may offer an alternative to hysterectomy. A device called a resectoscope cuts away the fibroids or an electrical current "evaporates" the fibroids. The resectoscope has been used for male prostate surgery for over 50 years. It has been modified so it can be used inside the uterus. The resectoscope is a hysteroscope with a built in wire loop that uses high-frequency electrical current to cut or coagulate tissue. The resectoscope has revolutionized surgery inside the uterus. After a laparoscopic or hysteroscopic myomectomy, the patient goes home the same day. Most women are back to normal activities within 7-10 days.

Abdominal Myomectomy

This is a surgical procedure, in which an incision is made in the abdomen to access the uterus, and another incision is made in the uterus to remove the tumor. Once the fibroids are removed, the uterus is stitched closed. The patient is given general anesthesia and is not conscious for this procedure, which requires a several-day hospital stay. Typical recovery is four to six weeks.

Myolysis

Then, using techniques such as coagulation or electrosurgery, the fibroids are removed and the uterine wall repaired. We use a bipolar needle or laser to perform "myolysis" of the fibroids. This destroys the fibroids and shrinks the blood vessels that feed them. A similar procedure called cryomyolysis uses liquid nitrogen to "freeze" fibroids. So this does not involve surgically cutting into the uterus, but instead, it uses techniques to coagulate the fibroids, which shrink to about half the size after surgery.

Uterine artery embolization

Known medically as uterine artery embolization, this approach to the treatment of fibroids blocks the arteries that supply blood to the fibroids causing them to shrink. It is a minimally-invasive procedure, which means it requires only a tiny nick in the skin, and is performed while the patient is conscious but sedated and feels no pain. Fibroid embolization is performed by an interventional radiologist, a physician who is specially trained to perform this and other minimally-invasive procedures.

Uterine artery Embolization

The interventional radiologist makes a small nick in the skin (less than one-quarter of an inch) in the groin to access the femoral artery, and inserts a tiny tube into the artery. The catheter is guided through artery to the uterus while the interventional radiologist guides the process of the procedure using a moving X-ray (flouroscopy). The interventional radiologist injects tiny plastic particles the size of grains of sand into the artery that is supplying blood to the fibroid tumor. This cut off the blood flow and causes the tumor (or tumors) to shrink. The artery on the other side of the uterus is then treated. Fibroid embolization usually requires a hospital stay of one night. Pain-killing medications and drugs that control swelling typically are prescribed following the procedure to treat cramping and pain. Many women resume light activities in a few days and the majority of women are able to return to normal activities within one week.

MRI-guided focused ultrasound ablation

Magnetic resonance guided focused ultrasound (MRGFU) is a non-invasive outpatient, procedure that uses high intensity focused ultrasound waves to ablate the fibroid tissue. During the procedure, an interventional radiologist uses magnetic resonance imaging (MRI) to see inside the body to deliver the treatment directly to the fibroid. The procedure is FDA approved for treating uterine fibroids, but is under investigation for the treatment of breast, prostate, brain and bone cancer. MRI scans identify the tissue in the body to treat and are used to plan each patient's procedure. MRI's provide a three-dimensional view of the targeted tissue, allowing for precise focusing and delivery of the ultrasound energy. MRI also enables the physician to monitor tissue temperature in real-time to ensure adequate but safe heating of the target. Immediate imaging of the treated area following MRGFU helps the physician determine if the treatment was successful. The ultrasound energy used in MRGFU can pass through skin, muscle, fat and other soft tissues. High-intensity ultrasound energy that is directed to the fibroid heats up the tissue and destroys it. This method of tissue destruction is called thermal ablation.

Hysterectomy

Hysterectomy is the surgical removal of the uterus (and usually of the cervix as well). It is the most common treatment for fibroids. In a hysterectomy, the uterus is removed either in an open surgical procedure or via laparoscopy. In case an open procedure is performed, it is considered major surgery and is performed while the patient is under general anesthesia. It requires an incision in abdominal wall to remove the uterus. It requires 3 to 4 days of hospitalization and the average recovery period is about six weeks. Hysterectomy can also be done laparoscopically provided the uterus is not too bulky because of fibroids. To know more about laparoscopic hysterectomy,

What are the Benefits and Drawbacks?

Today minimal invasive procedures have created a revolution in the world of surgery. The reason is that they cause less tissue-damage and scarring. So the recovery is also faster. Laparoscopy and hysteroscopy are two very common approaches for removing fibroids (myomectomy). Until recently, surgical removal of fibroids almost always involved a large abdominal incision (laparotomy) with a three-to-five day hospital stay and six-to-eight week recovery. The advantages of laparoscopic/hysteroscopic myomectomy are:

shorter hospital stay reduced recovery time reduced post-operative pain smaller incisions better cosmetic results

Side Effects or Complications

Fibroid embolization is considered to be very safe, however, there are some associated risks, as there are with almost any medical procedure. Most women experience moderate to severe pain and cramping in the first several hours following the procedure. Some experience nausea and fever. These symptoms can be controlled with appropriate medications. A small number of patients have experienced infection, which usually can be controlled with antibiotics. It also has been reported that there is a 1 percent chance of injury to the uterus, potentially leading to hysterectomy. These complication rates are lower than those of hysterectomy and myomectomy.

Myomectomy and hysterectomy also carry risks, including infection and bleeding leading to transfusion. Patients who undergo myomectomy may develop adhesions causing tissue and organs in the abdomen to fuse together, which can lead to infertility. In addition, the recovery time is much longer for abdominal myomectomy, generally one to two months. For more information, kindly visit : http://www.aasthahealthcare.com/Laparoscopic-Myomectomy-Fibroids-Treatment.htm ------------------------------------