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Laparoscopic Myomectomy

Fibroids and Myomectomy

A myomectomy is a surgery done to remove uterine fibroids while retaining the uterus. It is usually done in a women during child bearing age, so that her uterus can be saved and she can have children in the future.  

Symptoms

Uterine fibroids can cause: 
  •  Heavy periods 
  •  Painful periods 
  •  Infertility 
  •  Pelvic pressure 
  •  Increase in abdominal girth 
 The aim of a myomectomy is to remove the fibroids,and hence relieve the symptoms and improve the chance of fertility  

Techniques of Myomectomy

  1. LAPAROSCOPIC MYOMECTOMY: The surgery is performed through a few small incisions made on the abdomen. The fibroid is cut into pieces(Morceliation) and removed through a small incision.
  2. HYSTEROSCOPIC MYOMECTOMY: A fibroid that protrudes into the uterine cavity is called a submucosal fibroid,This is removed(Resected) through a hysteroscope inserted through the vagina and cervix.
  3.  ABDOMINAL MYOMECTOMY: A large open cut is made in the abdomen and the fibroid is removed. This should usually be reserved for when the fibroid is suspected to be malignant [cancer].  

What to Expect?

  1.  You will need to come on the morning of the surgery on an empty stomach
  2. You will be preparted for general anesthesia 
  3. Depending on the procedure you can go home late evening( Hysteroscopic myomectyomy) or might have to stay overnight(Laparoscopic myomectomy)  

Advantages of Laparoscopic/Hysteroscopic Myomectomies


  •  Less tissue trauma  
  • Less blood loss - few ml versus half a liter in open surgery  
  • Less postoperative pain - patients walk on the same day  
  • Faster recovery - patients can get back to work in a couple of days versus weeks that open surgery  
  • Requires Shorter hospital stay - 1 day versus 4-5 days for open surgery  
  • Better cosmetic results - smaller scars      
  • Less chances of wond infection     

Fertility & Laparoscopic Myomectomy

Women who have undergone a laparoscopic myomectomy have a good chance of improved fertility. Results are better in younger woman with only one fibroid We advice waiting 8-9 months before planning a preqnancy. Thls gives time for the uterus to heal  

Pregnancy Risks after a Laparoscopic Myomectomy

As the uterus has been operated upon, the scar on ther uterus makes that area a possibly weak area, which could rupture during labour, and, a Cesarean section may be advised around 38 weeks of pregnancy.  

Will Fibroids come back?

Yes,they can come back especially in: 
  •  Older women 
  •  Women who do not plan a pregnancy fast 
  •  Women who have had multiple fibroids   
And, therefore if a patient is not planning any further children, it is ALWAYS a better option to remove the uterus [hysterectomy], rather than remove only the fibroids.
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