Hysteroscopic myomectomy involves inserting a hysteroscope through the vagina and the cervix into the uterus. Hysteroscopes are so thin that they can fit through the cervix with minimal or no dilation. Because the instruments are inserted through the cervix no abdominal incisions are needed. The hysteroscope is a thin, telescope-like instrument that allows the doctor to view the fibroids. A resectoscope, which is a hysteroscope fitted with a wire loop that uses high-frequency electrical current to cut or coagulate tissue, is then inserted to remove the fibroids. The loop is placed around the fibroid, electrical energy passes through the loop, and the fibroid is cut loose. The fibroid can then be removed through the vagina.
This procedure is most often done on an "outpatient" basis under general anesthesia. There is usually minimal discomfort during hysteroscopy. It takes about 60 minutes to complete the procedure which is followed by a few hours of recovery time. Hysteroscopy can be used to remove fibroids on the inner wall of the uterus that have not grown deep into the uterine wall. Complications occur less than 1% of the time with hysteroscopic myomectomy.
Success of myomectomy varies depending upon the size, type and number of fibroids and the type of myomectomy performed. Complications and complication rates also vary depending upon the size, type and number of fibroids as well as the type of myomectomy performed.
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Explanation of Hysteroscopic myomectomy including illustration
See an overview of all uterine fibroid treatment options.