Scheduled for Da Vinci Myomectomy - Thanks to you!
This post is really a thank you because if I had not found this site, I would have believed my only options for my fibroids (one 9 cm, and a few smaller ones) was open abdominal surgery, or even a hysterectomy. Thanks to the advice I found in these forums, I persevered through three different doctors to find someone who could perform a less invasive procedure. My surgery is scheduled for 2/19/13, and I would like to share my experience in case it is helpful to someone else.
Since October of last year, I have been experiencing heavy, painful periods and constant abdominal pain/bloating. I finally sought medical help in December, when the fibroid became large enough for me to feel. I went to my primary care physician, who told me I had fibroids and would have to get a hysterectomy. Since I am 31 and still hoping for a family, I went home and cried so hard that my whole body hurt the next day. When I had finally regained my senses, I decided to consult with Dr. Google, and through the information here at HysterSisters, I discovered I had several options to try. I set about finding a gyno who could help. (I had been seeing my primary care doc for my gynecological needs before this, although in retrospect, I think that was a bad choice.)
The first gynecologist I saw told me that there was no option except an open abdominal myomectomy. He also warned me that he thought the inside of my uterus might have significant scarring from the procedure, and that about 5% of women who go in for myomectomies end up with hysterectomies due to irreparable uterine defects or uncontrollable bleeding. This information did not match what I had read/heard from others, so I decided to keep looking. The second doctor I saw was a little more encouraging and said she could start the procedure with the Da Vinci robot, but said there was about a 50% chance she would have to make an abdominal incision to finish the procedure. She told me that the problem was not so much the size of the tumor as its placement -- right under my belly button, where it would fill up the whole camera screen, which would potentially make the surgery unsafe. Her reasoning made a lot of sense, but she said a couple things that bothered me, like that no one could tell from an ultrasound how deeply the tumors were embedded in the wall of the uterus, and that a couple of my smaller fibroids could just be left alone. Although she was not nearly as alarmist as the first doctor, she did give me a big talk about how no doctor could guarantee that a myomectomy will not turn into a hysterectomy, which also made me uncomfortable.
Emboldened by other women's stories of robotic myomectomies for tumors larger than mine, I decided to seek one more opinion, and I hit the jackpot. The doctor I saw today assured me that it would be no problem to place the camera port a little higher in my abdomen, where my larger tumor would not block the view. She was also the first doctor to give me diagrams and explanatory literature, and she immediately told me about other surgeries she had done on cases similar to mine. Without my asking, she also provided a detailed explanation of how she would repair my uterus in layers to make sure that the scar was strong. Her ultrasound tech was able to see exactly how deeply my tumors were embedded (deep, but not to the point that she would have to breach the uterine cavity to remove them) and she said it would be no problem to remove them all in one operation. I knew instantly that this was the quality of care that I had been wanting, and I am so excited to have my surgery and get back to my life.
Thank you to everyone who has shared your stories here and gave me the courage not to settle for a harder surgery. I will come back and let you know how recovery goes!
Re: Scheduled for Da Vinci Myomectomy - Thanks to you!
Congrats on bring your own best advocate! My story is very similar to yours, except I'm 42 and don't want kids. But I wanted to keep my uterus for all the other reasons God put it there! I had to go through 4 doctors to find one who was confident performing a myomectomy (and sufficiently skilled for my comfort level).
I had da Vinci myomectomy on Jan. 2. My surgeon also located the camera port a little higher since my fibroids were clustered at the top of my uterus.
It's been a little over 2 weeks since my surgery and the recovery is not bad at all. Really the main trouble was post surgery constipation (which is very common) and it was difficult to find something to wear that didn't rub my incisions or put pressure on my belly. Long soft nightgowns and low rise boy shorts were fine for home but going outside in the freezing cold meant some creative adjustments. I cut the front part of the waistband off some leggings and wear them with tall boots and a soft sweater dress. :-)
To give you some encouragement, my aunt had an abdominal myomectomy 25 years ago for several large fibroids. She went in to have 2 healthy boys. Technology is so much better these days, so have confidence that your surgery will be a success!
If you're curious and not too squeamish, watch some YouTube videos of da Vinci myomectomy. You can see actual surgical videos that show everything, including removal if the fibroids and making the stitches. I found the videos really helpful in understanding my procedure and conversing with my doctor before and after surgery. Search YouTube for Pitter Myomectomy - that's a good one that's very long and unedited and involves removal of multiple fibroids of various sizes
Re: Scheduled for Da Vinci Myomectomy - Thanks to you!
There's a good list on this website somewhere about all the questions you should ask your doctor. I asked the these questions:
- Surgical history/experience doing myomectomies (da Vinci and other methods)
- # of years as a surgeon
- # of years using da Vinci
- # of da Vinci myomectomies and hysterectomies performed ever
- # performed monthly on average
- rate of conversion from da Vinci to abdominal/open
- rate of serious complications
My surgeon is a Proctor for da Vinci , meaning that he teaches other surgeons how to use the system. He is also the head of robotic gyn surgery for the Northern CA division of the hospital group.
Based on his answers to my questions, I felt really confident in relying on him to perform my myomectomy.
Don't feel awkward asking any doctor about their experience. Any good doctor should be happy to answer and mine was impressed that I took such a strong interest in my own care. He said most people don't get second opinions (I got 4!), dont do research, and just accept whatever the doc says.