Fibroids affect up to 80% of all women, and many struggle with symptoms for years before seeking surgical treatment. Minimally invasive removal of fibroids can relieve symptoms such as heavy menstrual bleeding and pelvic pain, and women get back to their normal lives in days vs weeks.
Minimally invasive myomectomy is a fertility sparing procedure. At The Center for Innovative GYN Care, advanced surgical specialists use the LAAM technique to remove fibroids with 2 small incisions. The LAAM procedure is one of the least invasive and most thorough uterus sparing surgeries for fibroids, and it is only performed on patients who are able to retain fertility. When fertility is no longer a viable option (1% or less), and fibroid symptoms are severe, a myomectomy is not recommended.
Hysterectomy is definitive treatment of fibroids and it is performed at CIGC with the DualPortGYN technique. Women generally recover in 1 week after DualPortGYN hysterectomy, and only two 5 mm incisions are used. A minimally invasive hysterectomy achieves permanent relief from symptoms, as opposed to myomectomy, where additional surgery may be necessary if fibroids recur.
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A myomectomy is a fertility-sparing procedure, designed to surgically remove fibroids. When fibroids become large, they can distort the uterus, making it harder for women to conceive and carry to term. Early treatment is important in order to prevent further issues, and seeking the help of a specialist is essential.
Thorough removal of fibroids is possible for many patients. A myomectomy is not definitive treatment as fibroids can still return. The only definitive treatment is hysterectomy. A minimally invasive myomectomy relieves symptoms such as heavy menstrual bleeding, and prepares the uterus for pregnancy. With CIGC’s LAAM approach, laparoscopic myomectomy is performed using 2 small incisions. Women recover in less than 2 weeks and many are able to conceive naturally after surgery. In order to achieve a healthy pregnancy, women should wait at least 3 months after surgery before pursuing fertility options as it is essential for the uterus to be completely healed.
The Center for Innovative GYN Care advanced surgical specialists use only minimally invasive techniques for fibroid removal. A laparoscopic approach in GYN surgery, with smaller and fewer incisions, helps patients recover faster and become mobile sooner.
When you are limited in mobility for an extended period of time, more than two weeks, muscles begin to decondition, or detrain. Walking promotes the flow of oxygen throughout the body, and maintains normal breathing function. Gastrointestinal and urinary tract function are improved, and with improved blood flow, wounds heal faster. Every patient’s recovery is different and should be monitored by a physician, but gradual and measured increase in movement and activity can help prevent prolonged recovery times.
CIGC’s advanced LAAM technique for laparoscopic fibroid removal provides such amazing results, many women choose to travel from out of state for surgery. With LAAM, our patients are able to recover faster, with less pain, and get back to work in less than 2 weeks. For many of them, the only options back home are more invasive open or robotic surgeries.
Ruchika S. from Rhode Island, had a very large fibroid, which did not cause any symptoms except making her stomach look big. She knew it had to be taken out. Ruchika researched her options and made the decision to travel for LAAM surgery.
DISCOVERING THE FIBROID
“Except for my stomach getting really big, I didn’t have any symptoms of fibroids at all,” Ruchika said. “No pain, no excessive bleeding. I’ve always had a relatively flat stomach, and I just turned 38. I remember back in January last year, I was working out, and not eating very much, and yet my stomach was getting bigger. I travel out of the country a couple of times a month. I run the international business for a medical device company. The crazy lifestyle that goes with that I just assumed it was part of it. I thought ‘Well, I’m getting older.’ I was resigning myself to it. Everything else was fine, except my stomach.”
“I’ve never been very good about doing the annual check-up. I finally went to see a regular gynecologist for a check-up. She checked my stomach and said ‘Well, what do we have here?’ I said what?” and she said ‘You’re pregnant.’ I’m pretty sure I’m not pregnant. I’ve had my period. ‘You’re four-to-five months pregnant.’ Obviously, I wasn’t pregnant, but she started doing tests and the ultrasound didn’t show anything. Then I had an MRI. The MRI showed that I had one gigantic fibroid. When I got my MRI results, I saw what it was and realized this needs to be taken out.”
SEARCHING FOR THE BEST FIBROID TREATMENT OPTION
Ruchika thoroughly researched options for fibroid removal. She learned embolization wasn’t possible due to the size, and most medical professionals recommended open surgery as the only option.
“During all of my research, I came across Dr. Paul MacKoul. I started doing more research on LAAM. Everyone in Rhode Island was saying I would have to have an open procedure. I was worried about my January schedule for travel and Dr. MacKoul was able to fit me in the week before Christmas. Timing wise it was great.”
The advanced LAAM technique was developed by CIGC founders Natalya Danilyants MD and Paul MacKoul MD to provide superior surgical results, and get women back on their feet faster. LAAM is only performed on patients who are able to retain fertility and has no limit for fibroid size, number, or location. CIGC surgeons use only two small incisions for this approach, and recovery is less than 2 weeks.
TRAVELING TO WASHINGTON DC FOR LAAM MYOMECTOMY
“Getting on a plane to go anywhere is not that a big deal for me at all. I live on the East Coast, my boyfriend lives on the West and my brother lives in New York, so regardless of where I had the surgery, they were going to have to travel to be with me. I was looking for the best surgeon. The one thing I have learned is that choosing the right surgeon matters.”
“I flew to DC, got the surgery done on Tuesday and was back in Rhode Island on Thursday. By Saturday I was fine to be on my own. I wasn’t up for going out and doing much for Christmas, but I really enjoyed being at home in my own space which I never get to do. I was off from work until New Year’s, and I had meetings in Europe and China the following week, so I was on a plane 2 and a half weeks after the surgery, and back at the gym. I don’t even think about it anymore. I have a flat stomach now!”
RECOVERY AFTER LAAM SURGERY
Ruchika’s fibroid was 1700 grams (close to 4 lbs). A normal uterus is 70 grams. Due to the size, most surgeons are only able to perform an open procedure, with 6-8 weeks recovery time. With LAAM, minimally invasive removal of a fibroid this size is possible.
“I was back to myself in a week and a half, and that was important to me. After two weeks I was back at work. Compared to the alternative, I’m so grateful. Everything is back to normal now. I’ve been working out. I went ice climbing two weekends ago, and I’m traveling for my normal insane life. Three weeks after the surgery I was running 7 to 8 kilometers.”
“Both my brother and boyfriend were able to take time off to be with me. Tuesday after the surgery I was a little out of it, but by Wednesday morning I was fine. Thursday evening, we all flew back to Rhode Island. I didn’t need any of the narcotics after the first day. I was on Advil the rest of the time.”
“Recovering at home was nice. My support system was there for me regardless of where I was. Not having to be in the hospital was nice. Having the surgery didn’t impact my work life at all. I took the last two weeks of the year off, and everyone else was taking vacation, so the timing was perfect for me. The whole experience was really good. ”
When it comes to a fibroid removal procedure, the surgical approach plays a great role in the patient’s recovery. The ability to perform thorough removal with smaller and fewer incisions leads to less complications and post-operative pain. Placement of incisions through the midline of the abdomen, bypassing the lateral abdominal muscles, allows for a safer surgery and a faster recovery.
CIGC surgeons developed the LAAM technique for myomectomy and the DualPortGYN approach for hysterectomy as definitive fibroid removal, to improve surgical outcomes. The use of the smallest incisions possible, including ultra-minilaparotomy, provides remarkable surgical results.
“Ultra-minilaparotomy is considered to be cosmetically superior as the incision is made along the natural cleavage of the skin folds. It is made in the midline and is very small, therefore, sparing the nerves and blood vessels on the lateral edges of the abdomen. It combines the best advantages of open and laparoscopic techniques.” said CIGC’s Rupen Baxi MD.
PATIENT TESTIMONIALS: RECOVERY AFTER ADVANCED FIBROID REMOVAL
CIGC patient and Maryland-based OBGYN, Dr. Valinda Nwadike, chose to undergo DualPortGYN hysterectomy as definitive fibroid treatment. Three days after her surgery, she was delivering babies.
“Dr. Natalya Danilyants advised me to take it easy for a week. The next day my son had a doctor’s appointment at 4PM and I felt well enough to sit with him in the waiting room, and then I went to dinner. Three days after the surgery, I was scheduled to work a 24 hour shift at the hospital, and delivered three babies. I was a little tired, but it didn’t slow me down. The next day, my husband and I drove to North Carolina. My husband drove, and I felt fine during the ride. I was told not to run for a couple of weeks, but I was fine doing boot camp a week later. I didn’t need any narcotics, I didn’t have any bleeding.” Dr. Nwadike said. Her full story is available here.
Lindsay (33) chose to travel from Dallas, TX for advanced laparoscopic myomectomy with the LAAM technique. She went through extensive research to find the option with the best possible outcome.
“My surgery was on a Thursday and I just flew in the day before. I didn’t know what to expect, I thought I was going to be in crazy pain at least for the weekend. But the next day, I woke up, and I felt great. We actually went site-seeing. That was amazing, the day after surgery I was up and moving. I used pain killers for about 3 nights. By the day I got back to Dallas, I was off painkillers. There wasn’t really pain, I just felt sore. It was completely different than I expected.” Lindsay said. You can read her story here.
TALK TO US ABOUT YOUR OPTIONS
A minimally invasive approach to fibroid removal is in the patient’s best interest. Many women residing outside the DC area choose to travel to CIGC for advanced GYN surgery as these procedures allow them to recover faster and to get back to their lives sooner. Patients recover in less than 2 weeks after LAAM myomectomy and within 1 week after DualPortGYN hysterectomy.
Women struggling with fibroids often face challenges when they try to become pregnant. Fibroids can make conception difficult, they can cause miscarriages and preterm labor. Many times they have waited too long and hysterectomy is the only option for treatment as there is no uterus left to salvage. It’s important that women are aware of the risks and seek treatment early, before extensive damage occurs.
LOOKING FOR THE BEST TREATMENT FOR FIBROIDS
A popular approach is to “watch and wait”. This is an outdated method as fibroids can grow very fast and it becomes harder to repair and preserve the uterus for fertility. Fibroids can obstruct fallopian tubes or the cervix making it harder for women to get pregnant. Fibroids that grow within the uterine lining, or develop within the muscle, can distort the uterine cavity. Removal of fibroids that distort the uterus dramatically reduces the risk of miscarriage.
Some medical professionals recommend uterine fibroid embolization, which can be appealing to women due to the non-invasive nature of the approach. This procedure however has limitations. In younger patients, long-term control is limited: additional fibroids can grow or the fibroid that was embolized could re-establish a blood supply. Embolization can also affect implantation of the embryo into the lining of the uterus where the baby grows. Read more in this WTOP article.
When it comes to surgical treatment, it should be performed by a laparoscopic specialist, with minimally invasive approach. With advanced surgical techniques like LAAM myomectomy, fibroids any number and size can be removed laparoscopically, in outpatient settings, and recovery is less than 2 weeks. The LAAM technique allows surgeons to feel the fibroids, even those localized deep in the muscle of the uterus, so they can be removed. Thorough removal is important to achieve long-term relief from symptoms and to increase the chances of a healthy pregnancy.
CIGC PATIENTS TALK ABOUT THEIR JOURNEY WITH FIBROIDS
CIGC patient Tonya suffered for years from fibroids and adenomyosis, and her symptoms got progressively worse.
“One month, I was hemorrhaging, and then all of a sudden, the bleeding stopped but the pain didn’t. I remember being in the house, and I was very weak. I was very anemic. I walked across the street to a Starbucks, I thought I needed something to eat. As soon as I was in Starbucks, I had to sit down, because I was feeling really dizzy, and really shaky. I went next door to an urgent care and they had to put me into a wheelchair because I couldn’t stand any longer. After all of the tests, they determined I was dehydrated from losing so much blood.”
CIGC’s hysterectomy patient from Maryland – Tracy J. – was struggling with fibroids that caused severe GYN symptoms. Tracy had not been sick before and she first ignored the signs when she first experienced pain and discomfort back in 2012. As years passed, she became extremely anemic due to very heavy bleeding and developed a small embolism in her leg that could have been fatal.
“The day I had to call my family and tell them that I was in the hospital with a blood clot, the hospital staff kept telling them that I could have died, which didn’t help their fears. I had an 8-week course of iron infusions. I had a baseline of 5. It’s supposed to be 12. I realized after that I had adapted to the amount of iron in my system.” Tracy said.
A friend spoke to Tracy about us years ago and she decided to reach out and seek surgical treatment when her symptoms got truly severe.
“At this point, I was having this horrendous bleeding, even though the clotting was managed, the bleeding was out of control and my stomach was always swollen. I now had a new job and great insurance, so I called The Center for Innovative GYN Care.”
“After the surgery, I am a one-woman marketing team, a grassroots campaign manager. I took a stack of business cards and I give them to people who I know have GYN problems. I’m happy to be here. I don’t believe in wasting a day. I’ve lost friends at young ages and have known people who have lived into their hundreds. I want to be one who lives a long life.”
Regina R. from Los Angeles, CA was diagnosed with fibroids years ago and was told she needs to have a hysterectomy. At the time, she was not ready to consider this procedure and decided to wait. She actually found a doctor in Beverly Hills, CA who said he could shrink fibroids with a tool that he had invented. When Regina went to see this doctor, he raised several red flags for her.
“He said ‘I can’t do the procedure on you, because there is literally no room in your abdomen to even put the tool in there. Your uterus is the size of 30 week pregnancy. You should have back pain, acid reflux.’ and he was looking at me in disbelief. That freaked me out. He said ‘You really need to take care of this. You can damage your kidneys. Your organs don’t have any room. The fibroids have filled in whatever space was left.’” Regina recounted.
“I drove home so upset. All of a sudden I was feeling the fibroid, whereas before this I hadn’t even noticed it. I do yoga 4-5 times per week. I was doing backbends and running around. I do power yoga for an hour and a half every day. I was doing 50 sit-ups at one point, and doing arm balances and headstands. I’ve been doing it for 6 years and I’m pretty advanced.”
“Once I got home I knew I had to take care of this. The trauma of open surgery wasn’t something I wasn’t willing to go through, especially still not having any noticeable symptoms, except that I didn’t have a flat stomach. It was pure vanity that started the whole thing. I still kept feeling like I didn’t need to do this, but at the same time I knew I did.”
CHOOSING TO TRAVEL FOR MINIMALLY INVASIVE HYSTERECTOMY
Regina’s doctor was only able to perform an open surgery, with 4-5 days in the hospital and 8 weeks recovery time. She researched her options online hoping to find a better approach and discovered CIGC.
“Reading all of the blogs and hearing these women’s testimonials, I realized I could do that. There is the expense of flying and hotel, but in the end it’s my body. My only options were open surgery here or flying to Washington, D.C. It was a no-brainer. After reading every person’s comments and blogs, and procedures, and looking up reviews on both doctors, I felt comfortable enough to say ‘I’m doing it.’ Mentally, I was now feeling the fibroid. I was ready to get it out of me and move on.” Regina said.
“I have a friend who is a gynecologist, who just told me to have the open surgery in LA. She said there was no way they could remove a uterus that big laparoscopically. My husband is good friends with her husband, and he was at their house prior to it. She kept saying ‘There’s absolutely no way they can do that. Don’t let her go!’ My husband stood firm saying ‘She’s done her research, I trust her and back her up.’”
LAPAROSCOPIC HYSTERECTOMY WITH DUALPORTGYN AT CIGC
With the DualPortGYN technique, minimally invasive hysterectomy can be performed for a uterus up to 20 pounds. Because of the minimally invasive approach, only two 5 MM incisions, recovery is minimal – 7 days. DualPortGYN hysterectomies use a specialized technique called retroperitoneal dissection that helps control blood loss and maps the pelvic cavity so the surgeon is able to fully visualize the pelvis.
“Open surgery was never even discussed. He does this surgery all the time, and it was business as usual. The phone consultation was very direct. I wanted someone straightforward for whom this kind of surgery is no big deal. I want to be one of a thousand, not one of a few.”
“The surgery was complex. When Dr. MacKoul came back in to talk to me he said that the ureter was wrapped around the uterus on both sides and some of the other organs were on top of it. I definitely needed to take care of it. It was remarkable. I obviously had a stomach, but I didn’t realize that the fibroid was going past my hipbone or my rib cage. It was the shape of a giant jellybean. After the surgery, my stomach is totally flat now.”
HAPPY WITH HER DECISION TO TRAVEL FOR SURGERY
The decision to travel for surgery is not an easy one to make, especially when family and friends have their doubts and try to change your mind. Regina however felt confident in her choice and went all the way. She recovered quickly after her laparoscopic hysterectomy, with very limited pain.
“I’ve been taking it easy, I’m basically back to normal, I didn’t really take any pain medication except to go to sleep the first couple of nights home. I’m totally feeling fine! People come to see me and it’s so weird because you don’t look like you’ve had surgery! I keep forgetting that I’ve had major surgery, you feel the incision a little bit, but it’s not anything that keeps me from doing anything.”
“Coming from a large city in LA where you can find an expert on everything, and having family and friends not understanding why I was going literally across the country for this procedure, my family especially was very uneasy. We are used to having everything within driving distance and even when I explained it to them, they couldn’t understand.”
“As the time got closer, it was a mental thing, I hadn’t met the doctor in person, I haven’t been to this hospital before, of course you get nervous. However, from the time that I called, to get information, to get my insurance approved, to speaking to the doctor, to having Emily call me and schedule the surgery, to the follow-ups for the lab work I needed, to the email communication, everything was so professional and so perfect. I didn’t have to worry about thinking about anything. The only thing I had to worry about was getting a flight and getting a hotel room.”
BOOK A CONSULT
If you would like to discuss your DualPortGYN hysterectomy with a CIGC specialist Dr. Paul J. MacKoul or Dr. Natalya Danilyants MD, call 888-SURGERY or contact us online. The Center for Innovative GYN Care has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the Washington DC area travel to CIGC through our travel program.
Many of our patients travel from out-of-town and from out-of-country for advanced minimally invasive GYN surgery at CIGC. Women who don’t have minimally invasive treatment options for their GYN condition closer to home can now benefit from CIGC’s groundbreaking techniques through our travel program. Innovative procedures like DualPortGYN and LAAM were developed by Paul MacKoul and Natalya Danilyants to improve surgical outcomes for patients and to help them recover faster.
GYN surgery for complex conditions like large fibroids and extensive endometriosis is now possible with only 2 small incisions and recovery in less than 2 weeks. Many times women are recommended open or robotic surgery and this is not longer necessary with advanced laparoscopic techniques.
We want to make traveling for GYN surgery from long distances as seamless as possible. Read about CIGC’s travel program and contact us online or at 888-SURGERY to book an appointment. CIGC has offices in Rockville, MD, Annapolis, MD and Reston VA.