In the event that the other techniques fail, the uterus or womb must be removed by a hysterectomy.
There are several methods:
This consists of filling the abdomen with air to create a larger space (rather like a balloon). Then, between one and three incisions of about 1 cm are made in order to insert the instruments and extract the uterus.
The laparoscopic technique is the least painful out of all the surgical techniques for treating fibroids.
Therefore, a laparoscopic hysterectomy for fibroids improves recovery and overall results.
The uterus can be removed through the vagina (when we practice a total hysterectomy without preserving the cervix) or by the morcellator (when the cervix is preserved and so the vagina is not opened).
A uterus that measures up to 15 or 20 cm can be removed using this technique.
In the event that it is not possible to use a less-aggressive technique, the possibility remains of performing a hysterectomy with traditional surgery.
It is then necessary to make a larger incision in the abdomen which can either be a phannenstiel-type (like a Caesarean section) or a midline incision.