Before we define a hysteroscopic myomectomy, it is important to understand what exactly a myomectomy is. A myomectomy is a procedure or treatment for removing fibroids. Fibroids are tumors which arise around the muscles of the uterus and form masses. In traditional myomectomy an incision is made and the fibroids are then removed by separating them and then cutting them away from the uterine tissue. A hysteroscopic myomectomy is different from the usual myomectomy procedure in the following way. A hysteroscopic myomectomy uses a hysteroscope which is a tube which has a light and camera attached to it. The cervix is used as the entry point for the hysteroscope in order to view the uterine cavity. A retroscope is also used in place of a hysteroscope. A retroscope refers to a hysteroscope that has a wire loop attached to it. It uses high frequency electrical current to cut or coagulate the tissue. This is inserted and place around the fibroid. The electrical energy cuts through the fibroid and thus helps to get rid of it.
The heat from this instrument sears the blood vessels and therefore blood loss is minimal. The fibroid is then removed through the vagina. A small camera is attached to the telescope and the view is projected onto a video monitor. This enables the surgeon to perform the surgery while sitting in a comfortable position and magnifies the image as well. There is no need for any incision at all in this kind of myomectomy. The hysteroscope is inserted through the vagina in to the cervix with minimal or no dilation at all.
A hysteroscopic myomectomy can only be performed on submucosal fibroids. Submucosal fibroids are those fibroids that are within or bulging into the uterine cavity. Anesthesia is needed for hysteroscopic myomectomy surgery as the surgery can take up to one or two hours and may otherwise be uncomfortable for the patient. Hysteroscopic myomectomy recovery is not very long. Quick recovery time is the greatest advantage of having hysteroscopic myomectomy carried out.
Patients are allowed to go home the same day and most women get back to normal activity, exercise and work within one of two days of having a hystersocopic myomectomy. Hysteroscopic myomectomy complications occur less than 1% of the time after this procedure has been carried out. The complications and the rate of complications of a hysteroscopic myomectomy depend on various factors such as the type, size and number of fibroids.
Studies show that hysteroscopic myomectomy have been of great help to women who suffer from submucous fibroids. The hysteroscopic myomectomy CPT code is 58561.