We do not have a difficult situation The patient needs to perform a myomectomy She has 2 2.5 (1 knot double) myomatous node This large interstitial node, which is located low along the anterior wall Diameter 6.5 centimeters There is an even smaller subserosal node that is located in the bottom.
But there is another 1 interstitialsubmucous node, which deforms the uterine cavity And which is in direct contact with a large interstitial node Which is located on the front wall And precisely because we will have to remove a large knot, to investigate the bottom of the wound We clip the uterine arteries In order to do it in more comfortable (dry) conditions.
Because leaving a submucous node 2.0 cm in diameter after surgery is bad And the actual presence of this submucosal node Stumped other s There was a discussion about what to do hysteroresectoscopy or myomectomy It is important that the patient no longer plans a pregnancy she is 45 years old.
But she does not want to remove the uterus We went to meet it, because the technical capabilities allow you to remove nodes without problems I must thank my assistant Maxim He picked up such an easy dynamic music Which to some extent reflects the very mood for this operation That is, it is for us a standard, welldeveloped, safe operation technique.
Which is for us . i would not say a routine We love our work, it can not be routine for us But such standard surgical intervention What I’m doing now is not an example to follow I cut out a piece of myometrium to make a smaller hood If the patient planned a pregnancy so do not!.
It is necessary to make an ordinary linear section But I did so that it was easier to sew a wound The tool is essentially helped by the type of a powerful clamp 10 mm pulley Such a clamp allows you to make a good traction for the unit 5 mm pimple does not allow you to manipulate nodes like this it’s not so reliable! And now I sew the wound through a special 12 mm trocar for sewing.
It allows to enter the game into the abdominal cavity without straightening it Trocars from VECTEC Standard sewing technique 1 row of seams, pick up the bottom of the wound Here is the submucous part of the node, which gave al symptoms (menometrorrhagia), anemic to the patient Hormonal treatment was performed before the operation, but it had no al effect.
Myoma Uterine Fibroids What is Myoma Causes Symptoms and Treatment for Myoma
A fibroid is a benign tumor that mainly consists have muscular tissue and usually grows inside the uterus. Fibroids are also called myomas. Its size ranges widely, from a small tumor the size of a pea to a large tumor almost the size of the uterus. Myomas are classified into three types, depending on the location where they are.
Found. The intramural myoma, a fibroid that grows in the muscular wall of the uterus. This subserosal myoma, a fibroid located just beneath the outside mucosal covering of the uterus. Here the fibroid projects to the outside and occasionally remains connected with the uterus.
Only through a small stalk. the submucosal myoma, a tumor that grows beneath the surface of the uterus lining. Therefore, this type of fibroids can grow into the uterine cavity. The actual causes have development of a fibroid are still unclear. However, it has been documented that fibroids are associated with high levels of.
Estrogen, the female sex hormone. Fibroids can only developed during reproductive years of women. Following menopause, the production of estrogen decreases which will usually cause fibroids to shrink or disappear. Myomas are more common in nonpregnant and infertile women. In general, fibroids are asymptomatic.
Or associated with just a few complaints if any complaints. if any complaints occur, then the location, size and type of the fibroid are the major factors. Fibroids can affect nearby structures. They can cause compression of the bladder, which may lead to urinary complaints, or may obstruct the intestine, which may result in constipation. Other complaints can be:.
Backaches, abdominal problems, menstrual flow disturbances. Fibroids can impede normal childbirth, which may require caesarean delivery. Fibroids relatively more often lead to miscarriages. Whenever fibroids cause symptoms, they need to be removed or shrinked.
Medications sometimes cause fibroid to shrink by blocking the production and secretion of estrogen. In other cases, surgery may be required to remove the fibroid. The type of surgery depends on the location of the fibroid. Sometimes it’s possible to remove the fibroid with the help of the tube.
Entered through the vagina and the procedure is called hysteroscopic myomectomy. In other cases, surgery through the abdominal wall may be necessary. In the case of a large fibroid, hysterectomy may be the only solution. This option only applies when there is no desire to have more children. You general practitioner can give you more.