3 Questions with Mayra Thompson, M.D.

You can avoid a hysterectomy to remove uterine fibroids and increase your chance for pregnancy. Here’s how.

About 600,000 hysterectomies are performed each year in the U.S., with about one in every three done as treatment for fibroids (tumors) on the uterus. Myomectomy — surgically removing the fibroids while preserving the uterus — has developed as an alternative for women of childbearing age, or women of any age, who don’t want a hysterectomy.

Now, UT Southwestern surgeons are taking it one step further with robotic myomectomy.

Q: WHAT HAPPENS DURING A ROBOTIC MYOMECTOMY?

Dr. Thompson: I make four small incisions in the abdomen to insert the robot’s camera and instrument arms. Next,

I inject medication to decrease bleeding and then use the robot’s tiny instruments to make an incision in the uterus. I remove the fibroids from the surrounding tissue, then use a special device to cut them into smaller pieces inside the abdomen so they can be removed through one of the small incisions. The uterus is repaired by carefully suturing the tissue to reconstruct a normal anatomy. Many patients are able to go home the same day as the surgery and return to normal activities in about two weeks.

Q: ARE ROBOTIC MYOMECTOMIES AS EFFECTIVE AS OTHER METHODS IN REMOVING UTERINE FIBROIDS?

Dr. Thompson: Yes, the fibroids are removed successfully and efficiently. Uterine preservation is generally the same whether it’s traditional surgery, laparoscopic surgery, or robotic myomectomy. However, the future option of pregnancy is improved with the robotic approach since it reduces trauma to the uterus and allows for better reconstruction.

If a woman wants to have children or maintain her uterus, this surgery may be her best chance.

Q: HOW DOES ROBOTIC MYOMECTOMY INCREASE THE CHANCES OF GETTING PREGNANT COMPARED TO OTHER SURGICAL METHODS?

Dr. Thompson: Traditional open surgery leads to greater amounts of internal scar tissue, and laparoscopic myomectomies haven’t always allowed surgeons to do the level of repair needed while keeping the uterus in good enough shape for future pregnancies. Robotic myomectomy provides the surgeon better views of the uterine fibroids and what’s around them so there’s less unnecessary damage, a more precise closing of the wound, and less overall blood loss. All of this means less damage to the uterus and less scar formation, which increase the chances of future pregnancy after uterine surgery.

 


Dr. Thompson, Associate Professor of Obstetrics and Gynecology, is trained in minimally invasive procedures. In addition to seeing patients at UT Southwestern, she also instructs physicians here and elsewhere in the use of minimally invasive techniques. To schedule an appointment with Dr. Thompson, call 214-645-8300.