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Hysterectomy pp 413–427Cite as

Symptomatic Fibroids as Main Indication for Laparoscopic Hysterectomy and Their Handling

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Abstract

In a book on hysterectomy techniques a detailed evaluation of myomectomies has its stand as more than 30 % of hysterectomies are performed because of large or symptomatic fibroids.

Uterine fibroids are the most frequent benign tumors of the female genital tract. Fibroids are associated with a variety of clinical problems, e.g. pain and pressure symptoms, bleeding disorders, bulk-related symptoms or infertility. For women wishing to preserve their uterus, fibroids can be surgically removed by hysteroscopy, laparoscopy or laparotomy. While hysterectomy remains the only definitive solution, many alternative treatment possibilities for uterine preservation are available today. The indication for a specific treatment has to be taken carefully after considering alternative treatment methods, such as expectant management, medical treatment or interventional radiologic methods, and after obtaining informed consent from the patient. The optimal method of treatment takes into account the patient’s interests and wishes and the practical feasibility in the clinical setup. Surgical skills and experience play an important role as surgical procedures on the uterus are not without risk and can lead to severe complications. The decision to operate anticipates an improvement of the initial situation and, therefore, the ideal surgical approach is of utmost importance. Today, a sequence of laparoscopic and hysteroscopic surgical steps with adequate instrumentation and knowledge of suturing guarantees a satisfying surgical outcome of myomectomy if hysterectomy is not desired.

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Acknowledgement

The authors thank Nicole Guckelsberger and Dawn Rüther for editing the manuscript.

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  1. Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Liselotte Mettler & Ibrahim Alkatout

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  1. Liselotte Mettler
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  2. Ibrahim Alkatout
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Correspondence to Ibrahim Alkatout .

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  1. Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Ibrahim Alkatout

  2. Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Liselotte Mettler

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Mettler, L., Alkatout, I. (2018). Symptomatic Fibroids as Main Indication for Laparoscopic Hysterectomy and Their Handling. In: Alkatout, I., Mettler, L. (eds) Hysterectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-22497-8_30

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  • DOI: https://doi.org/10.1007/978-3-319-22497-8_30

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