In this episode of BackTable OBGYN, Dr. Mark Hoffman is joined by Dr. Sarah Rassier, a minimally invasive gynecologic surgeon and Director of the Fibroid Clinic at Mayo Clinic, to discuss the multiple treatment modalities of fibroids with a focus on laparoscopic myomectomy. Drs. Hoffman and Rassier discuss the various factors they consider when deciding on the most suitable approach for a myomectomy. Specifically, they touch on pre-surgical patient optimization, the use of laparoscopic techniques in surgery, and the significance of efficient incision planning and closure. Dr. Rassier also highlights the practice of using preventative measures, such as iron infusions and Lupron, in certain patients to manage fibroids before surgical intervention. The conversation wraps up with a discussion about how future developments could potentially revolutionize fibroid management. --- SHOW NOTES 00:00 - Introduction and Overview of the Podcast 03:32 - Discussion on Fibroids and Their Different Treatment Options 06:40 - The Future of Fibroid Treatment 09:17 - Patient-Centered Decision Making in Fibroid Treatment 11:40 - Preparation and Approach for Myomectomy 13:18 - Discussion on the Use of MRI in Fibroid Treatment 15:55 - The Role of Laparoscopy in Myomectomy 29:00 - Umbilicus vs. Suprapubic Approach 32:04 - Cosmetic Considerations in Surgery 32:27 - - C-sections After Myomectomies? 34:51 Instruments and Techniques for Fibroid Removal 36:28 - Minimizing Blood Loss in Surgery 38:47 - The Importance of Efficient Closure in Surgery 44:46 - Tissue Extraction Techniques 49:02 - The Future of Myomectomy