FREQUENTLY ASKED QUESTIONS

How is a myomectomy different from a hysterectomy?

A hysterectomy, although it will get rid of your fibroids, it will also get rid of your uterus, ending any pregnancy possibility forever. A myomectomy, on the other hand, is the removal of the fibroids from your uterus, but leaving your uterus in. If you desire to maintain your childbearing potential, this is an important distinction for two reasons:

1. 1. Removal of fibroids may cause damage to your uterus, so it is not just a simple matter of only getting rid of your fibroids, but requires a technique that respects the uterus and its tissue.
   2. Meticulous dissection and expert surgical technique must be used to safeguard your uterus a functional organ for pregnancy. The ideal result is removing your fibroids but leaving as much uterine tissue and its architecture as possible.

Such meticulous dissection requires the advanced technology that a robotic myomectomy provides.

What about shrinking fibroids without surgery?

There are certainly other ways to decrease the size of fibroids without surgery:

• • Hormonal Therapy. This can put you into a temporary menopause-like state, which many younger women find intolerable; for women who are nervous about their biological clock, this type of approach takes time, time best spent attempting pregnancy.
  • Sound Waves. Focused ultrasound can crumble fibroids, but this is not a totally benign method, possibly causing sepsis-like symptoms requiring hospitalization (hospitalization that may be longer than what was needed for a robotic myomectomy).
  • Arterial Occlusion. Also, not a completely benign procedure, in which the artery is threaded with a catheter to block off the blood supply to the fibroid. Those with numerous fibroids—as is often the case—make this method impactable.

The one glaring disadvantage of all of these is that the attempt to eliminate your fibroids may fail and you may have to resort to surgery anyway.

What about a myomectomy? Can’t that fail?

It is possible to miss some fibroids even with surgery, but these are usually so tiny that they aren’t visible at the time of myomectomy. The only way to prevent this altogether is to have a hysterectomy, which is not an option when a woman wants to keep her pregnancy options open.

Can fibroids come back?

No. If fibroids are seen again on ultrasound after a myomectomy, either they were too tiny to see at myomectomy or they’re new. Fibroids that are removed surgically can never “come back.”

What’s the best type of myomectomy?

Myomectomy can be done with

• • an open abdominal incision;
  • laparoscopy; or
  • robotic myomectomy.

Surgery is the definitive therapy, but it is best done using a minimally invasive technique such as the robotic approach. Today’s same-day, minimally invasive and robotic techniques, the kind in which Dr. Bozdogan is a specialist, shortens recovery time, important if fibroids are removed due to infertility. His state-of-the-art technology also makes possible complete fibroid removal while sparing the architecture of the uterus. When fertility is no longer desired, Dr. Bozdogan’s robotic approach can even perform a hysterectomy, which means a permanent removal of the uterus’ fibroids, too, if indicated. Dr. Bozdogan always discusses all of the possible strategies before doing any surgery.

What exactly is this robot?

Dr. Bozdogan uses tiny, cosmetic incisions in your abdomen that accommodates the da VinciⓇ robotic surgery system, which allows magnified, stereoscopic (3D), dexterous microsurgery. The procedure is done under general anesthetic, and it can last from under an hour to several, depending on the size and number of fibroid(s) unique to your case.
Dr. Bozdogan, as a specialist in myomectomy, has done thousands of robotic procedures and even teaches the technology and techniques to surgeons wishing to begin incorporating robotic surgery into their own practices.

For myomectomy, does one size fit all?

In any consideration of surgery, your specific case is a unique presentation fraught with the need for individualized approaches and therapeutic choices. An important part of your treatment is planning, and Dr. Bozdogan respects that your unique circumstances require a carefully planned strategy in which he invites you to take part. When you undergo surgery by Dr. Bozdogan, you are partnering with him as part of a team. He is also an educator, and you will have a thorough understanding of your problems, treatments, and even unlikely complications.