Slide 8

There are four types of surgical interventions for treating fibroids. The first is an open myomectomy, which has a longer recovery time and more risks. It's recommended when the benefits outweigh the risks and depends on the size and number of fibroids. The second option is a robotic-assisted or laparoscopic myomectomy, which is less invasive and has a faster recovery time. The third option is a hysteroscopic myomectomy, which is the most minimally invasive, but can only be done for smaller fibroids. The last option is a hysterectomy, which is for those who don't want to have children or haven't responded to other treatments. There are four different surgical interventions that we can do. The first is an abdominal, which is an open myomectomy. This requires the longest recovery and carries additional risk, but recommended when benefits outweigh the risk. The recommendation depends on the size and number of fibroids that are present. This allows the surgeon greater access to the fibroids, but it does require cesarean delivery if the patient becomes pregnant afterwards. The robotic-assisted or laparoscopic myomectomy is a minimally invasive procedure that's longer, but it does carry fewer risks. It lowers the risk of adhesions, and there's a faster recovery with less pain. This also requires a cesarean delivery if the patient becomes pregnant in the future. There's a hysteroscopic myomectomy, which is the most minimally invasive, by inserting the hysteroscope into the uterine cavity through the vagina and cervix. But these fibroids must be mucosal and smaller than 4 centimeters to be able to do this kind of procedure. And then the definitive treatment is a hysterectomy, and that's for those who do not desire fertility or have had insufficient response to alternative treatments.