title: Safety and economical innovations regarding surgical treatment of fibroids.
abstract: Uterine leiomyomas are the most frequent benign tumors of the female genital tract. Fibroids are associated with a variety of clinical problems, e.g. bleeding disorders, bulk-related symptoms or infertility. For women wishing to preserve their uterus, fibroids can be surgically removed by hysteroscopy, laparoscopy or laparotomy. The purpose of our review is to show that hysterectomy offers the only definitive solution. The indication for treatment has to be taken carefully after weighing up alternative treatment methods, such as expectant management, medical treatment or interventional radiologic methods, and after obtaining informed consent. 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; therefore, the ideal surgical approach is of utmost importance.
authors.affiliation: a Department of Gynecology and Obstetrics , University Hospitals Schleswig-Holstein , Kiel , Germany.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Alkatout
authors.affiliation: a Department of Gynecology and Obstetrics , University Hospitals Schleswig-Holstein , Kiel , Germany.
authors.forename: Liselotte
authors.initials: L
authors.lastname: Mettler
authors.affiliation: a Department of Gynecology and Obstetrics , University Hospitals Schleswig-Holstein , Kiel , Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Günther
authors.affiliation: a Department of Gynecology and Obstetrics , University Hospitals Schleswig-Holstein , Kiel , Germany.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Maass
authors.affiliation: a Department of Gynecology and Obstetrics , University Hospitals Schleswig-Holstein , Kiel , Germany.
authors.forename: Christel
authors.initials: C
authors.lastname: Eckmann-Scholz
authors.affiliation: a Department of Gynecology and Obstetrics , University Hospitals Schleswig-Holstein , Kiel , Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elessawy
authors.affiliation: b Department of Gynecology and Obstetrics , Community Hospital Dormagen , Dormagen , Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Anapolski
mesh_terms: D017115:Catheter Ablation / Q000379:methods; D002983:Clinical Competence; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015907:Hysteroscopy / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000601:surgery*; D063186:Uterine Myomectomy / Q000379:methods; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Fibroid; endoscopy; hysteroscopy; laparoscopy; myomectomy; robotic-assisted surgery; supracervical hysterectomy; total laparoscopic hysterectomy