Smit Bharat Solanki: The Most Important Part of a Myomectomy Happens Before Surgery
Smit Bharat Solanki, Director and Clinical Lead – Reproductive Medicine and Surgery at Parul Sevashram Hospital, shared a post on LinkedIn:
“The Most Important Part of a Myomectomy Happens Before Surgery
In the management of uterine fibroids, discussions often focus on the surgical approach- hysteroscopic, laparoscopic, robotic, or open. However, the most critical step frequently occurs before the patient enters the operating room.
Fibroid mapping.
A comprehensive preoperative assessment should extend beyond documenting the number and size of fibroids. Equally important are their precise location, FIGO classification, relationship to the endometrial cavity, and potential impact on fertility and surgical complexity.
A well-executed fibroid map helps answer several important questions:
- Which fibroid is responsible for the patient’s symptoms?
- Is the uterine cavity distorted?
- What is the likely impact on fertility and reproductive outcomes?
- What is the optimal surgical route?
- What challenges might be anticipated during surgery?
The same uterus can present multiple fibroids of similar size but vastly different clinical significance. Treatment decisions are therefore guided not only by dimensions, but by anatomy.
As surgeons, our goal is not simply to remove fibroids. Our goal is to provide individualized treatment based on symptoms, reproductive goals, imaging findings, and surgical feasibility.
A well-mapped uterus leads to a well-planned surgery. A well-planned surgery leads to better outcomes.”
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