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A new website for gynaecologists interested in the surgical management of fibroids is now on line. www.fibroidsurgery.org
Hysteroscopic myomectomy is done using a small telescope inserted
through the vagina and cervix into the uterus.
The telescope can be fitted with miniature instruments
(eg. scissors, cutting loop, laser) which is used
to remove or destroy the fibroid(s). The procedure
is monitored on a colour television via a small
type of surgery is suitable for small fibroids
which are mainly sited inside the cavity of the
uterus, although deeper fibroids can sometimes
also be removed. With larger fibroids, the procedure
may have to be repeated, but this is unusual.
Complications with this type of surgery are relatively
Relatively minor (day case) surgery
No external scars
No risk of scar tissue in pelvis
Only suitable for small/few fibroids
Fibroids have to be mainly in the uterine cavity
Hysteroscopy can also be used for treatment. Operative
hysteroscopes are slightly larger instrument fitted with
mechanical instruments (e.g. scissors, biopsy forceps,
graspers), electrodes (e.g. resectoscope) or laser.
One of the most effective hysteroscopic procedures is
myomectomy. Fibroids are usually excised but can also
be vaporised. This type of surgery is indicated provided
the fibroids are not too large or numerous, and situated
mainly inside the uterine cavity.
Hysteroscopic surgery can also be used to remove polyps,
divide uterine septa, free adhesions (Asherman's syndrome)
and destroy the endometrium (endometrial ablation).