Dr. Konstantinidis MD, PhD, FACS - General Surgeon & Director of Bariatric, Laparoscopic & Robotic Surgery of Athens Medical Center.
Uterine fibroids are a common condition in women of childbearing age, the treatment of which often requires surgical removal, with or without preservation of the uterus.
Combining the latest developments in medical technology and science with respect and sensitivity to each patient, Dr. Konstantinidis and his Surgical Team offer internationally acclaimed and innovative treatments.
Dr. Konstantinidis and his Surgical Team have extensive experience in treating uterine fibroids using the state-of-the-art robotic system da Vinci Xi, at Medical Center of Athens, with high success rates.
What are Fibroids?
Uterine fibroids are benign tumors that grow on the wall of the uterus and are often discovered accidentally during a regular checkup.
About 20-40% of women of reproductive age have fibroids in the uterus, which grow either individually or in groups under the influence of female hormones, estrogens.
They usually increase in number and size with age, while after menopause they shrink and depending on their size may disappear.
Fibroids can be responsible for frequent and heavy bleeding, chronic pain or pressure on the pelvis, and in some cases infertility in young women.
What Causes Fibroids?
The cause of uterine fibroids is not yet known, although some studies link them to a genetic background.
To date, no external factor has been identified that favors the development of fibroids in a woman.
What are the risk factors for Fibroids?
There are several characteristics that can increase the risk of developing fibroids, including:
- Age: Fibroids are more common as women get older, especially in their 30s and until menopause. After menopause, fibroids are much less likely to form and if they already exist, they usually shrink.
- Family history: If another family member has been diagnosed with fibroids, then the risk of their occurrence in other female members and future generations increases.
- Obesity: Women who are overweight are at a higher risk – two to three times higher than average – for fibroids.
What are the symptoms of uterine Fibroids?
Most women with fibroids will have no symptoms at all. However, in cases where large or many fibroids are developed, the following symptoms may occur:
- heavy or prolonged periods
- bleeding between periods
- pain and pressure in the pelvis
- pain during intercourse
How are uterine Fibroids diagnosed?
Usually, fibroids are detected during a regular gynecological examination.
Imaging tests can confirm the initial diagnosis by physical examination.
Two basic tests are preferred:
Ultrasonography: It is the most common test for fibroids. An abdominal ultrasound or transvaginal ultrasound is performed so that doctors can get an image of the uterus and ovaries.
Magnetic Resonance Imaging (MRI): This test allows the doctor to clarify the size, number and location of fibroids, as well as to distinguish between fibroids and adenomyosis, which is sometimes misdiagnosed.
Treatment – How are uterine Fibroids treated?
Since most fibroids stop growing and may even shrink as a woman approaches menopause, the doctor’s initial recommendation may be for follow-up.
However, some fibroids may require more active treatment, depending on:
- the extent of the symptoms
- the age of the patient
- fertility goals
- the number and size of fibroids
- previous treatments that did not work
- related health problems
Conservative treatment of fibroids, which includes non-steroidal anti-inflammatory drugs, hormones and GnRH agonists analogues, can alleviate the symptoms.
However, only with surgical treatment can the definitive treatment of fibroids be achieved with great success.
What type of surgery should I choose?
Surgical treatment of fibroids includes various methods and techniques, such as:
Myomectomy: Sometimes also called fibroidectomy, myomectomy refers to the removal of fibroids while preserving the uterus. This method is recommended for women who want to have children, as well as for those who refuse to have their uterus removed.
Hysterectomy: It concerns the removal of the uterus in women.
Uterine Fibroid Embolization (UFE): A new method of treating fibroids is the embolization of their blood vessels, which causes them to shrink. However, the lack of studies regarding the long-term success of the method significantly limits its application.
What is Robotic Myomectomy?
An evolution of the laparoscopic approach is robotic myomectomy. Dr. Konstantinidis and his Surgical Team perform this procedure with the da Vinci Xi robotic system, which uses the most advanced technology available to overcome the challenges of laparoscopic fibroid removal.
Robotic myomectomy allows is performed with incomparable precision, flexibility and stability of movement, while the surgeon enjoys high quality 3D magnification of the surgical field allowing him to navigate the robotic arms as if he were inside the patient’s body!
Robotic myomectomy is minimally invasive because it is performed through 4 micro-incisions.
The application of modern technology in the hands of an experienced surgeon, allows the removal of fibroids maintaining the uterus even after previous cesarean sections or other operations in the uterus.
The High-Definition images provided by the robotic system allow for accurate identification of each patient’s anatomy, the vessels and the fibroid detachment plan during resection.
The uterus is sutured, as in open surgery.
The fibroid is removed from the abdomen into tissue pieces, without the need for an additional surgical incision.
What are the advantages of Robotic Myomectomy?
For women who want to treat their fibroids effectively while maintaining their uterus, robotic myomectomy offers many advantages over the open procedure, such as:
- less postoperative pain, since large incisions are avoided
- less blood loss and no need for a transfusion
- shorter hospital stay, as wound healing is faster
- faster recovery and return to daily and family life
- less complications and postoperative infections, due to minimal tissue injury during surgery
- less postoperative adhesions
- precise and strong suturing of the uterine wall in multiple layers
- minimally invasive surgery in women with large, intramural or inaccessible fibroids
- optimal cosmetic outcome with small incisions
What is a Hysterectomy?
Hysterectomy involves the surgical removal of the uterus and is the second most common gynecological surgery, after cesarean section.
In the United States alone, more than half a million women undergo hysterectomy each year.
By the age of 60, about one in three women is estimated to need to have her uterus removed for some reason.
Hysterectomy is divided into total and subtotal (supracervical), in which the cervix is not removed for better support of the pelvic floor, reduced morbidity of the woman and keeping intact her sexuality.
With the removal of the uterus, menstruation stops.
However, by preserving the ovaries in premenopausal women, hormone levels are maintained and the woman is protected from the symptoms of premature menopause.
What is Robotic Hysterectomy?
Robotic surgery is an evolution of laparoscopy, in order to compensate for the technical difficulties of the latter and to allow major and demanding gynecological procedures to be performed with techniques of minimally invasive surgery.
This is achieved to the fullest extent with the use of the da Vinci robotic system, by Dr. Konstantinidis and his Surgical Team, for hysterectomy procedures.
The advantages of the da Vinci robotic system include the greater accuracy, stability and flexibility in the movements of the robotic arms, their ability for complex maneuvers using special robotic tools, as well as the three-dimensional display with digital magnification of the surgical field, allowing the surgeon to intervene even in small and inaccessible places.
Overall, the use of the da Vinci robotic system creates an ergonomic environment for the surgeon, who performs the operation relaxed and seated on the robotic console.
The patient, for her part, enjoys the benefits of minimally invasive surgery to an even greater degree than conventional laparoscopy.
Postoperative pain after robotic hysterectomy is even less, both because there is no extensive injury and surgical incisions, and because much less air (carbon dioxide) is used for the required abdominal distension.
Recovery is fast and a return to daily life is achieved in just 24 hours.
What is Single-Site Robotic Hysterectomy?
Single-Site Robotic Surgery is an even more recent innovation in the field of laparoscopic surgery.
The innovation lies in the introduction of robotic tools into the patient’s abdomen through a single, small incision of 2.5 cm and not through 4 incisions, as in traditional laparoscopic and robotic hysterectomy.
The first Single-Site robotic subtotal hysterectomy in Greece (and the third internationally) was performed with absolute success by the surgeon Dr. Konstantinidis and his colleagues in November 2011 to a 53-year-old woman with uterine fibroids.
The operation lasted 3 hours and was completed without blood, leaving a small scar 2.5 cm above the navel.
The patient was discharged within 15 hours of surgery without analgesics or other medications.
Since then, Dr. Konstantinidis and his Surgical Team have performed a great number of robotic hysterectomy procedures with high success rates.
Why choose Dr. Konstantinidis?
The Robotic Surgery Team of Athens Medical Center, under the direction of Dr. Konstantinidis, with the participation of experienced gynecologists has performed a great number of robotic myomectomy and hysterectomy procedures, with high success rates and patient satisfaction rates.
Combining the latest developments in medical technology and science with respect and sensitivity to each woman, Dr. Konstantinidis and his Surgical Team offer internationally acclaimed and innovative treatments.