I think i'm too young to have a hysterectomy, but i have heavy bleeding and fibroids. what is the difference between a robotic laparoscopic myomectomy and a robotic hysterectomy?

Uterine preservation: A myomectomy removes the fibroids and leaves the uterus; a hysterectomy removes the entire uterus. With a myomectomy, fertility is preserved, menstrual periods persists. The robot facilitates a better repair of the uterus during a myomectomy, but does not provide much benefit during a laparoscopic hysterectomy.

Future fertility: A myomectomy removes the fibroids but keeps the uterus intact for patients who want children in the future. The risk is that you may grow more fibroids later on and need another surgery. If you want more children this is a better choice. If not then a hysterectomy would be a more definitive surgery. Robotic surgery allows more precision, less blood loss and a faster recovery.

Depends on goals: If desire more children then myomectomy, just removal of the fibroids. If family complete then vaginal or laparoscopic hysterectomy (only removal of the uterus & fibroids, not ovaries = unchanged hormones) should be preferred as there is less pain and a faster recovery than an abdominal hysterectomy with its large incision. The robot is just a tool to perform laparoscopic surgery.

Pregnancy?: This presentation is common in women with fibroids. Future pregnancy is a consideration which may lead to a recommendation for myomectomy where the fibroids are removed leaving the uterus intact. If pregnancy is not desired, the options include medical therapy, myomectomy or for definitive treatment, hysterectomy where the uterus is removed. Robotc surgery offers shorter recovery, less blood loss.

Why not UFE?: Uterine fibroid embolization (ufe) treats all of the fibroids and the associated symptoms while at the same time allow women to keep their uterus. It is a non-surgical procedure which is safer, less invasive, and has a shorter recovery than surgical options. Myomectomy can end up as hysterectomy and has a much higher recurrence rate than ufe (since fibroids are often left behind after myomectomy).

Situational: Whether robotic or other approach- myomectomy is inidicated in women who have heavy bleeding due to fibroids and still want ot bear children in the future. If you are done childbearing, then hysterectomy or uterine artery ablation may be more appropriate. In some young women, hysteroscopic resection may be a good option.

Tissue removed: The myomectomy removes only the fibroids whereas the hysterectomy removes the whole uterus and all the fibroids in it. The main reason for a myomectomy is if you desire to become pregnant. If not, a myomectomy often results in more surgical blood loss, possible continued heavy periods, & recurrence of fibroids. You will not go into menopause as long as the ovaries are not removed.

Than you are: Hysterectomy is largely unnecessary for fibroids which are benign. Robotic procedures are much more expensive than regular laparo and again unnecessary (dont need added dexterity of robotic arms for an amputation procedure) for hysterectomy . Robot can have advantages (over regular laparo) in myomectomy depending on fibroid #, location. Consider 2nd opinion with interventional radiologist for ufe.

You have options.: If you want to have children, or more children, then you should consider the robotic myomectomy. You should not have a hysterectomy if you think you might want to be pregnant again. Also, if you chose an endometrial ablation for the bleeding, you are closing the door on future pregnancies. If you have an ablation, you still need to use contraception.

What is removed: A myomectomy is the removal of the myoma (fibroid) from the uterus. The hysterectomy is the removal of the entire uterus. For women who do not plan to have more children it usually makes more sense to remove the uterus, but it is still the patient's choice and it could be appropriate to keep the uterus even with no plans for additional pregnancies.