Zhuang Feiqi, deputy head of the Kaohsiung Chang Gung Department of Obstetrics and Gynecology, pointed out that Ms. Huang's uterine fibroids have enlarged her uterus to the point where she is 22 weeks pregnant.

(Photo by reporter Xu Lijuan)

[Reporter Xu Lijuan/Kaohsiung Report] 52-year-old Ms. Huang from Kaohsiung had huge fibroids in her uterus, which stretched her uterus to the size of a small jade watermelon. If she was 22 weeks pregnant, she went to the doctor and found a degenerative fibroid with a diameter of 12 cm, and a The fibroid with a diameter of 7 cm was located in the cervix. Due to the high difficulty of the operation, the doctor recommended Da Vinci to perform a total hysterectomy through the natural vaginal orifice. The excised uterus weighed 1030 grams.

Ms. Huang said that because her stomach was very distended, she would feel a hard lump pressing on her stomach when sleeping on her side, and her menstrual period lasted for half a month. After more than half a month, she went to the obstetrics and gynecology department first and found uterine fibroids It is as big as a small jade watermelon. After being transferred to Kaohsiung Chang Gung Hospital for treatment, it was originally chosen to use Haifu knife (ultrasonic focused knife) to remove the fibroids, but the team of doctors thought it was impossible to cure it, so they used the least destructive Da Vinci surgery The uterus and fibroids were removed through the vagina. Not only was there no wound at all after the operation, but also no painkillers were needed. I could even get out of bed and walk around as soon as I returned to the ward. I was discharged from the hospital 2 days later.

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Zhuang Feiqi, deputy head of the Department of Obstetrics and Gynecology of Chang Gung, Kaohsiung, pointed out that the uterus of a normal woman is about the size of a fist, but Ms. Huang's uterus is as big as six months pregnant because of her huge uterine fibroids. The removal methods include traditional laparotomy and laparoscopic surgery. And there is no wound at all. Da Vinci's non-porous uterus is removed from the natural orifice of the vagina. Due to the problem of wound recovery period in traditional surgery, although the wound in laparoscopic surgery is small, because it cannot be turned, there may not be such a large space to operate. Removal of such a large fibroid, because Ms. Huang’s condition is more complicated, and total hysterectomy does not have suturing problems like removing only fibroids, so it is recommended to use Da Vinci to enter the operation from the vagina, and remove the excised uterus piece by piece. The postoperative recovery period is fairly quick.

According to Zhuang Feiqi, about 20-80% of women have uterine fibroids before the age of 50, because fibroids may be in the muscle wall, submucosal or subserosal, depending on the location, size, and number, about 30-40% of uterine fibroids Cancer patients are symptomatic.

Take Ms. Huang's condition as an example. Since the fibroids grow outward, it is very likely that the menstruation will not be heavy when it grows. It only presses the bladder and there will be a little frequent urination. But if it grows in the inner membrane cavity, it may be a small one Heavy menstrual bleeding.

Kaohsiung Chang Gung will introduce the fourth-generation Da Vinci robotic arm in 2021. The picture shows the medical team performing a hysterectomy on a patient.

(Provided by Kaohsiung Chang Gung)

Zhuang Feiqi reminded that uterine fibroids are related to women's estrogen. Estrogen in overage women will stimulate uterine fibroids to grow until they reach the maximum state before menopause. After menopause, estrogen will not grow again, but fibroids will not It will disappear because of this, and it can only shrink a little, but it is impossible to disappear. Whether it needs to be dealt with depends on the individual situation.

Lin Zhizhe, vice president of Kaohsiung Chang Gung, said that Da Vinci surgery has been developed in Taiwan for many years. Because of the good results, the Ministry of Health and Welfare is evaluating the payment of some surgical items; It has been updated to the 4th generation, and there are 10 doctors in the Department of Gynecology who are qualified to operate Da Vinci surgery, including hysterectomy, hysteromyomectomy, ovarian benign tumor resection, endometriosis, uterine tubal reconstruction surgery, and pelvic reconstruction Surgery, etc., although the price is expensive, taking Ms. Huang's operation as an example, it is about 230,000 yuan, but the advantage is in exchange for the comfort and recovery time of the operation. More than 70% of the patients can be discharged from the hospital on the second day after the operation. Nearly 2,000 cases have been performed.

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keywords

  • cervix

  • Uterine fibroids

  • No wound surgery

  • hysterectomy

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